Healthcare Provider Details

I. General information

NPI: 1861578940
Provider Name (Legal Business Name): PRISCILLA VALERIE MAROTTA PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9343 SW 60TH TERRACE RD
OCALA FL
34476-4494
US

IV. Provider business mailing address

9343 SW 60TH TERRACE RD
OCALA FL
34476-4494
US

V. Phone/Fax

Practice location:
  • Phone: 954-336-2965
  • Fax:
Mailing address:
  • Phone: 954-336-2965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3973
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPY3973
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: