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General NPI Number Information
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NPI Number | 1912513755
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Entity Type | Individual
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Provider Name | MARIAN F MADEN
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Gender | Female
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Dates
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Enumeration Date | 09/17/2020
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 505 FRONT ST STE 202
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City | LYNDEN
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State | WA
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Zip | 98264-1922
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Country | US
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Telephone | 360-504-8337
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Fax |
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Provider Business Mailing Address
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Address Line | 1840 MAIN ST APT 21
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City | LYNDEN
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State | WA
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Zip | 98264-9753
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Country | US
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Telephone |
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH61452906
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MG.61106694
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License Number State | WA
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