Provider Demographics
NPI:1669865929
Name:CZ, MARYLYNN CZ (BSW)
Entity type:Individual
Prefix:MS
First Name:MARYLYNN CZ
Middle Name:
Last Name:CZ
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-1554
Mailing Address - Country:US
Mailing Address - Phone:352-726-3726
Mailing Address - Fax:941-492-2170
Practice Address - Street 1:12497 TAMIAMI TRL S
Practice Address - Street 2:SUITE 4
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-1447
Practice Address - Country:US
Practice Address - Phone:941-492-4300
Practice Address - Fax:941-492-2170
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker