Provider Demographics
NPI:1922313618
Name:CASARES-THORNDIKE, MARI T (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARI
Middle Name:T
Last Name:CASARES-THORNDIKE
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 1:3999 SHERIDAN ST
Mailing Address - Street 2:STE 201
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3635
Mailing Address - Country:US
Mailing Address - Phone:954-200-0300
Mailing Address - Fax:
Practice Address - Street 1:3999 SHERIDAN ST
Practice Address - Street 2:STE 201
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3635
Practice Address - Country:US
Practice Address - Phone:954-200-0300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7529103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling