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General NPI Number Information
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NPI Number | 1992892939
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Entity Type | Individual
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Provider Name | MARILYN AUDREY MOSKOWITZ MFT LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | 300 S IMPERIAL AVE STE 6
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City | EL CENTRO
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State | CA
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Zip | 92273
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Country | US
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Telephone | 760-356-0068
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Fax | 760-352-5422
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Provider Business Mailing Address
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Address Line | PO BOX 1203
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City | EL CENTRO
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State | CA
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Zip | 92244-1203
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Country | US
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Telephone | 760-356-0068
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Fax | 760-352-5422
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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 | LCS11375
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License Number State | CA
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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 | MFT16488
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License Number State | CA
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