Healthcare Provider Details

I. General information

NPI: 1013252543
Provider Name (Legal Business Name): MARCELLA ADRIA ARNOLD M.A., M.F.T. TRAINEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2012
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N MURRAY ST
BANNING CA
92220-5528
US

IV. Provider business mailing address

245 N MURRAY ST
BANNING CA
92220-5528
US

V. Phone/Fax

Practice location:
  • Phone: 951-849-8812
  • Fax: 951-755-8915
Mailing address:
  • Phone: 951-849-8812
  • Fax: 951-755-8915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: