Provider Information for 1194904649
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KAY LYNN MARBLE LMSW, ACSW, CAC-R
Sex: Female
NPI: 1194904649
Last Updated: 2009-10-20
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1194904649 | ||||||||||||
| Enumeration Date | 2007-11-01 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 106 FRANKLIN ST LUDINGTON, MI 49431-1845 United States Phone: 231-233-5657 | Fax: | ||||||||||||
| Primary Practice Address | 106 FRANKLIN ST LUDINGTON, MI 49431-1845 United States Phone: 231-233-5657 | Fax: | ||||||||||||
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