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General NPI Number Information
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NPI Number | 1962748327
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Entity Type | Individual
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Provider Name | RESHELLE CATHERINE MARINO PH.D., LPC-S, NCC
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Gender | Female
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Dates
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Enumeration Date | 12/12/2012
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Last Update Date | 12/12/2012
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Provider Practice Location Address
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Address Line | 4428 CONLIN ST SUITE A
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City | METAIRIE
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State | LA
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Zip | 70006-2124
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Country | US
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Telephone | 504-450-5940
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Fax |
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Provider Business Mailing Address
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Address Line | 4428 CONLIN ST STE A
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City | METAIRIE
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State | LA
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Zip | 70006-2124
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Country | US
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Telephone | 504-450-5940
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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 | LPC-S 4254
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License Number State | LA
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