Provider Demographics
NPI:1528442530
Name:L'HEUREUX, MARIELLE LOUISE
Entity type:Individual
Prefix:MISS
First Name:MARIELLE
Middle Name:LOUISE
Last Name:L'HEUREUX
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 1:3374 PRINCETON CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5520
Mailing Address - Country:US
Mailing Address - Phone:408-508-8208
Mailing Address - Fax:
Practice Address - Street 1:3374 PRINCETON CT
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5520
Practice Address - Country:US
Practice Address - Phone:408-508-8208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer