Provider Demographics
NPI:1972158285
Name:MARX, ALLISON REND
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:REND
Last Name:MARX
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 1:560 S ST LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-4390
Mailing Address - Country:US
Mailing Address - Phone:323-261-4900
Mailing Address - Fax:
Practice Address - Street 1:560 S ST LOUIS ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-4390
Practice Address - Country:US
Practice Address - Phone:323-261-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-04
Last Update Date:2019-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist