Organization Name: | JENNIE N. MARQUEZ |
NPI Number: | 1023449972 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIE N. MARQUEZ (CEO) |
Mailing Address: | 4777 E State St Suite 1 Rockford |
State: | IL US |
Postal Code: | 611082273 |
Phone Number: | 8159771425 |
Fax Number: | |
NPI Enumeration Date: | 12/03/2013 |
NPI Last Update Date: | 12/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149.008535 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |