Healthcare Provider Details

I. General information

NPI: 1285563155
Provider Name (Legal Business Name): XAIMARA MARQUEZ
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MOUNT PLEASANT AVE
PROVIDENCE RI
02908-1940
US

IV. Provider business mailing address

28 BEAUFORT ST
PROVIDENCE RI
02908-4407
US

V. Phone/Fax

Practice location:
  • Phone: 401-403-5902
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: