Provider Demographics
NPI:1285177881
Name:FIELD, MARLA J (MA)
Entity type:Individual
Prefix:MRS
First Name:MARLA
Middle Name:J
Last Name:FIELD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10011 FIELDCREST DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-8339
Mailing Address - Country:US
Mailing Address - Phone:810-844-3162
Mailing Address - Fax:
Practice Address - Street 1:10011 FIELDCREST DR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-8339
Practice Address - Country:US
Practice Address - Phone:810-258-9108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361004524101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6361004524OtherSTATE OF MICHIGAN - LARA
MI6361004524OtherSTATE OF MICHIGAN - LARA