Doctor Name: | JOANNE M MARINO |
NPI Number: | 1154423960 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, NCC, CCMHC |
License Number: | 000108 |
Business Practice Address: | 21 Strickland Rd Cos Cob, CT - 068072727 |
Business Phone Number: | 2038690216 |
Business Fax Number: | |
Mailing Address: | 21 Strickland Rd, COS COB |
State: | CT |
Postal Code: | 068072727 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/02/2006 |
NPI Last Update Date: | 03/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 000108 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |