Provider Demographics
NPI:1497461891
Name:RUBEOR, MARIELLE L (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIELLE
Middle Name:L
Last Name:RUBEOR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 WALDEN MILL WAY
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-2807
Mailing Address - Country:US
Mailing Address - Phone:443-904-4760
Mailing Address - Fax:
Practice Address - Street 1:175 ADMIRAL COCHRANE DR STE 110
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-8445
Practice Address - Country:US
Practice Address - Phone:410-571-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27297104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker