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General NPI Number Information
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NPI Number | 1548299100
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Entity Type | Individual
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Provider Name | MARLENE MILLER JURON LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 5317 FRUITVILLE RD # 4
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City | SARASOTA
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State | FL
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Zip | 34232-6402
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Country | US
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Telephone | 941-302-5008
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Fax |
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Provider Business Mailing Address
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Address Line | 5317 FRUITVILLE RD # 4
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City | SARASOTA
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State | FL
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Zip | 34232-6402
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Country | US
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Telephone | 941-302-5008
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 09040444044
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW18517
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License Number State | FL
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