Provider Demographics
NPI:1326727876
Name:CORCHO, MARILEY (BSN)
Entity Type:Individual
Prefix:
First Name:MARILEY
Middle Name:
Last Name:CORCHO
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6830 SW 163RD PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-4442
Mailing Address - Country:US
Mailing Address - Phone:786-210-7785
Mailing Address - Fax:
Practice Address - Street 1:11780 SW 89TH ST STE 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-2181
Practice Address - Country:US
Practice Address - Phone:786-587-7449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty