Provider Demographics
NPI:1902448830
Name:HESTER, MARRIAH
Entity Type:Individual
Prefix:
First Name:MARRIAH
Middle Name:
Last Name:HESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2361 S ATTUCKS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93706-4802
Mailing Address - Country:US
Mailing Address - Phone:559-367-5329
Mailing Address - Fax:
Practice Address - Street 1:1690 W SHAW AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3518
Practice Address - Country:US
Practice Address - Phone:559-255-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician