Provider Demographics
NPI:1861686925
Name:GUIDOTTI, MARILYN G (LICENSED INDEPENDENT)
Entity type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:G
Last Name:GUIDOTTI
Suffix:
Gender:F
Credentials:LICENSED INDEPENDENT
Other - Prefix:MISS
Other - First Name:MARILYN
Other - Middle Name:IRENE
Other - Last Name:GUIDOTTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:822 KIRKWALL DRIVE
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-1761
Mailing Address - Country:US
Mailing Address - Phone:330-666-3317
Mailing Address - Fax:330-665-2228
Practice Address - Street 1:565 SOUTH CLEVELAND MASSILLON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-3019
Practice Address - Country:US
Practice Address - Phone:330-665-2227
Practice Address - Fax:330-665-2228
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI16071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical