Provider Demographics
NPI:1417150582
Name:KATELL, MARILYN BEVERLY (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:BEVERLY
Last Name:KATELL
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 1:10996 CANARY ISLAND CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-8204
Mailing Address - Country:US
Mailing Address - Phone:954-465-8020
Mailing Address - Fax:
Practice Address - Street 1:10996 CANARY ISLAND CT
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-8204
Practice Address - Country:US
Practice Address - Phone:954-465-8020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2345101YM0800X
FLMT1235106H00000X
FL7763103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist