Provider Demographics
NPI:1225284169
Name:MARRERO, LUCY (PHD)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:
Last Name:MARRERO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14260 W NEWBERRY RD
Mailing Address - Street 2:# 165
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-2765
Mailing Address - Country:US
Mailing Address - Phone:352-219-0988
Mailing Address - Fax:
Practice Address - Street 1:14260 W NEWBERRY RD
Practice Address - Street 2:#165
Practice Address - City:NEWBERRY
Practice Address - State:FL
Practice Address - Zip Code:32669-2765
Practice Address - Country:US
Practice Address - Phone:352-219-0988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5117103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist