Healthcare Provider Details

I. General information

NPI: 1750147559
Provider Name (Legal Business Name): ANA CLARE MARQUES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2024
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 PARK FORTY PLZ STE 125
DURHAM NC
27713-5249
US

IV. Provider business mailing address

100 PINEWILD DR STE 2A
ROCHESTER NY
14606-4200
US

V. Phone/Fax

Practice location:
  • Phone: 919-912-5599
  • Fax:
Mailing address:
  • Phone: 585-922-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA22173
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: