Provider Demographics
NPI:1619701752
Name:MURRAY, MARION ANGELA
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:ANGELA
Last Name:MURRAY
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 1:6063 CAMELIA DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-5571
Mailing Address - Country:US
Mailing Address - Phone:281-650-2207
Mailing Address - Fax:
Practice Address - Street 1:6063 CAMELIA DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-5571
Practice Address - Country:US
Practice Address - Phone:281-650-2207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician