Provider Demographics
NPI:1104050384
Name:GUMA, MARIE
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:GUMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 NW 167TH ST
Mailing Address - Street 2:SUITE #102
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-4838
Mailing Address - Country:US
Mailing Address - Phone:305-624-7450
Mailing Address - Fax:305-623-7893
Practice Address - Street 1:14853 SW 152ND TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-5544
Practice Address - Country:US
Practice Address - Phone:305-624-7450
Practice Address - Fax:305-623-7893
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health