Provider Demographics
NPI:1447557921
Name:CUCKLER, MARJAN ATTAIE (MSW,LSW)
Entity Type:Individual
Prefix:MRS
First Name:MARJAN
Middle Name:ATTAIE
Last Name:CUCKLER
Suffix:
Gender:F
Credentials:MSW,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 N SANDUSKY ST
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-1632
Mailing Address - Country:US
Mailing Address - Phone:614-560-0518
Mailing Address - Fax:
Practice Address - Street 1:230 N SANDUSKY ST
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1632
Practice Address - Country:US
Practice Address - Phone:614-560-0518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.00247101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical