Individual
SUSAN MARICLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1342 CYPRESS TRACE DR, MELBOURNE, FL 32940-1624
(321) 258-9096
Mailing address
1342 CYPRESS TRACE DR, MELBOURNE, FL 32940-1624
(321) 258-9096
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/12/2014
Last updated
06/12/2014
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