Individual
MARIELLE O. ASENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1717 S. ORANGE AVE, SUITE 100, NEMOURS CHILDRENS CLINIC, ORLANDO, ORLANDO, FL 32806-2946
(407) 650-7715
(407) 650-7124
Mailing address
PO BOX 191, PROVIDER ENROLLMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW9404
FL
1041C0700X
Clinical Social Worker
SW9404
FL
Other
Enumeration date
03/14/2011
Last updated
09/27/2011
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