Provider Demographics
NPI:1316339799
Name:HAWLEY, MARILYN
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:HAWLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:
Other - Last Name:HAWLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:700 LAUREL AVE
Mailing Address - Street 2:APT. 2B2
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-4176
Mailing Address - Country:US
Mailing Address - Phone:484-437-3779
Mailing Address - Fax:
Practice Address - Street 1:375 89TH ST
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-1802
Practice Address - Country:US
Practice Address - Phone:650-301-8650
Practice Address - Fax:650-301-8639
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor