MEDICARE: MARLI CHRYS HABAN REFUERZO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1770119018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLI CHRYS HABAN REFUERZO

Provider Business Mailing Address
First Line	:	5901 GREEN VALLEY CIR STE 466
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6970
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 GREEN VALLEY CIR STE 466
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6970
Country	:	US
Telephone Number	:	818-788-1003
Fax Number	:	818-788-1135

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2020
Last Update Date	:	08/11/2025

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