Provider Demographics
NPI:1013597913
Name:CAIN, MARLEE MARIE (ITDS)
Entity Type:Individual
Prefix:
First Name:MARLEE
Middle Name:MARIE
Last Name:CAIN
Suffix:
Gender:F
Credentials:ITDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5063 SW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7621
Mailing Address - Country:US
Mailing Address - Phone:352-355-0853
Mailing Address - Fax:352-509-7688
Practice Address - Street 1:5063 SW 56TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7621
Practice Address - Country:US
Practice Address - Phone:787-425-1852
Practice Address - Fax:352-373-4455
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1013597913Medicaid