Provider Demographics
NPI:1689956104
Name:DUBIN, MARIANNE I (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:
Last Name:DUBIN
Suffix:I
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N UNIVERSITY DR STE 116A
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6084
Mailing Address - Country:US
Mailing Address - Phone:754-214-6442
Mailing Address - Fax:
Practice Address - Street 1:7890 PETERS RD BLDG G
Practice Address - Street 2:SUITE 105
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-4028
Practice Address - Country:US
Practice Address - Phone:754-214-6442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW23341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical