Provider Demographics
NPI:1295030856
Name:SKANE, MARINA
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:SKANE
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 1:611 DRUID RD E STE 704
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3939
Mailing Address - Country:US
Mailing Address - Phone:802-727-0246
Mailing Address - Fax:803-229-6609
Practice Address - Street 1:611 DRUID ROAD E
Practice Address - Street 2:SUITE 704
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3939
Practice Address - Country:US
Practice Address - Phone:802-727-0246
Practice Address - Fax:813-229-6609
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2954106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist