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General NPI Number Information
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NPI Number | 1528266301
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Entity Type | Individual
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Provider Name | MARIAN BRENT ELLIOTT LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 7220 ROSEDALE HWY #3
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City | BAKERSFIELD
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State | CA
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Zip | 93308-5871
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Country | US
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Telephone | 661-679-7738
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Fax | 661-679-7738
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Provider Business Mailing Address
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Address Line | 15711 JOHNSON RD
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City | BAKERSFIELD
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State | CA
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Zip | 93314-7834
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Country | US
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Telephone | 661-679-7738
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Fax | 661-679-7738
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS21625
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License Number State | CA
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