Provider Demographics
NPI:1871363325
Name:DUMONT, MARILYN
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:DUMONT
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 1:1499 N 159TH AVE APT 1158
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-7193
Mailing Address - Country:US
Mailing Address - Phone:480-651-4490
Mailing Address - Fax:
Practice Address - Street 1:1499 N 159TH AVE APT 1158
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-7193
Practice Address - Country:US
Practice Address - Phone:480-651-4490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care