Provider Demographics
NPI:1528395035
Name:COTT, MARIEANNE (PHD)
Entity Type:Individual
Prefix:
First Name:MARIEANNE
Middle Name:
Last Name:COTT
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:E23 CALLE GUADALUPE
Mailing Address - Street 2:EL ALAMO URBANIZATION
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4513
Mailing Address - Country:US
Mailing Address - Phone:787-453-9582
Mailing Address - Fax:
Practice Address - Street 1:E 23 GUADALUPE STREET
Practice Address - Street 2:EL ALAMO URBANIZATION
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4513
Practice Address - Country:US
Practice Address - Phone:787-707-1090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TS0200X
PR103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool