Provider Demographics
NPI:1538155536
Name:ERGENER, MARIE-CLAUDE (PHD)
Entity type:Individual
Prefix:
First Name:MARIE-CLAUDE
Middle Name:
Last Name:ERGENER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 MADRUGA AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3164
Mailing Address - Country:US
Mailing Address - Phone:973-650-9650
Mailing Address - Fax:305-663-5809
Practice Address - Street 1:1450 MADRUGA AVE STE 310
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3164
Practice Address - Country:US
Practice Address - Phone:908-273-7269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-25
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8509103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical