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NPI Code Detail

MEDICARE: MARLAYNA ASHLEY ANDERSON LMSW

MEDICARE:   MARLAYNA ASHLEY ANDERSON  LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLMSW-18070AZ

General Provider Information

NPI Number : 1184203358
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLAYNA ASHLEY ANDERSON LMSW
Provider Business Mailing Address
First Line : 7047 S 30TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85042-6013
Country : US
Telephone Number : 602-575-5359
Fax Number :
Provider Business Practice Location Address
First Line : 4801 S LAKESHORE DR STE 111
Second Line :
City : TEMPE
State : AZ
Zip : 85282-7156
Country : US
Telephone Number : 480-442-9089
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2021
Last Update Date : 04/05/2021

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Directions to “ MARLAYNA ASHLEY ANDERSON LMSW” Practice Location

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