Provider Demographics
NPI:1053482356
Name:LAGUERRE, MARSHAWNA (BS)
Entity type:Individual
Prefix:
First Name:MARSHAWNA
Middle Name:
Last Name:LAGUERRE
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1748 INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE D-1
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-2122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1748 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE D-1
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-2122
Practice Address - Country:US
Practice Address - Phone:941-359-1927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL767870300Medicaid