Provider Demographics
NPI:1336897073
Name:RUBIO, MARLIN DAYANA (MASTER SOCIAL WORKER)
Entity Type:Individual
Prefix:MRS
First Name:MARLIN
Middle Name:DAYANA
Last Name:RUBIO
Suffix:
Gender:F
Credentials:MASTER SOCIAL WORKER
Other - Prefix:
Other - First Name:MARLIN
Other - Middle Name:DAYANA
Other - Last Name:AVILA-LEON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1188 BROADWAY APT 4
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2317
Mailing Address - Country:US
Mailing Address - Phone:516-244-4140
Mailing Address - Fax:
Practice Address - Street 1:1188 BROADWAY APT 4
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-2317
Practice Address - Country:US
Practice Address - Phone:516-244-4140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP109770104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker