Provider Demographics
NPI:1447306196
Name:MARIN, PAULETTE MARIA
Entity type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:MARIA
Last Name:MARIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAULETTE
Other - Middle Name:M
Other - Last Name:MCLARNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 COYOTE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508
Mailing Address - Country:US
Mailing Address - Phone:505-473-2933
Mailing Address - Fax:505-983-5017
Practice Address - Street 1:1494 ST FRANCIS DR
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505
Practice Address - Country:US
Practice Address - Phone:505-699-4482
Practice Address - Fax:505-983-5017
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK68171100000X
NM788171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist