Provider Demographics
NPI:1245507607
Name:MARRERO, JULIETTA (LMHC)
Entity type:Individual
Prefix:MRS
First Name:JULIETTA
Middle Name:
Last Name:MARRERO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 NW 107TH AVE STE G
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2734
Mailing Address - Country:US
Mailing Address - Phone:305-594-8666
Mailing Address - Fax:
Practice Address - Street 1:1470 NW 107TH AVE STE G
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2734
Practice Address - Country:US
Practice Address - Phone:305-594-8666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 11022101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health