Doctor Name: | MARK MARQUEZ |
NPI Number: | 1447267893 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | C000174 |
Business Practice Address: | 1120 7 Lks N West End, NC - 273769756 |
Business Phone Number: | 9106739111 |
Business Fax Number: | 9106736202 |
Mailing Address: | Po Box 9, WEST END |
State: | NC |
Postal Code: | 273760009 |
Phone Number: | 9106739111 |
Fax Number: | 9106736202 |
NPI Enumeration Date: | 08/01/2006 |
NPI Last Update Date: | 03/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | C000174 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |