Provider Demographics
NPI:1871699330
Name:EPPLER-NOBLE, MARILYN JEAN (MA, MFT)
Entity type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:JEAN
Last Name:EPPLER-NOBLE
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:MRS
Other - First Name:MARILYN
Other - Middle Name:JEAN
Other - Last Name:EPPLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, MFT
Mailing Address - Street 1:PO BOX 5261
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95352-5261
Mailing Address - Country:US
Mailing Address - Phone:209-529-7807
Mailing Address - Fax:209-529-7919
Practice Address - Street 1:909 15TH ST
Practice Address - Street 2:SUITE 8
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-1130
Practice Address - Country:US
Practice Address - Phone:209-529-7807
Practice Address - Fax:209-529-7919
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29832106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist