Doctor Name: | STEPHANIE MICHELLE MARQUES |
NPI Number: | 1154730620 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 69172 |
Business Practice Address: | 2928 W 5th St Ft Worth, TX - 761072242 |
Business Phone Number: | 8176325516 |
Business Fax Number: | 8173326489 |
Mailing Address: | 2928 W 5th St, FT WORTH |
State: | TX |
Postal Code: | 761072242 |
Phone Number: | 8176325516 |
Fax Number: | 8173326489 |
NPI Enumeration Date: | 08/08/2014 |
NPI Last Update Date: | 08/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 69172 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |