| Doctor Name: | NICOLE MARQUISS |
| NPI Number: | 1174915581 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., L.M.H.C |
| License Number: | MH13070 |
| Business Practice Address: | 3055 Orchard Walk Ln Green Cove Springs, FL - 320437235 |
| Business Phone Number: | 9044796220 |
| Business Fax Number: | |
| Mailing Address: | 2950 Halcyon Ln, Suite 703 JACKSONVILLE |
| State: | FL |
| Postal Code: | 322236689 |
| Phone Number: | 9044796220 |
| Fax Number: | |
| NPI Enumeration Date: | 02/22/2015 |
| NPI Last Update Date: | 02/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH13070 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |