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NPI Code Detail

MEDICARE: JACQUELINE MARQUEZ MFT, LPC

MEDICARE: JACQUELINE MARQUEZ MFT, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorPC011292PA

General Provider Information

NPI Number : 1164086740
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE MARQUEZ MFT, LPC
Provider Business Mailing Address
First Line : 60 ABBEY LN APT 7B
Second Line :
City : NEWARK
State : DE
Zip : 19711-6835
Country : US
Telephone Number : 302-383-0625
Fax Number :
Provider Business Practice Location Address
First Line : 325 CHESTNUT ST STE 800
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19106-2608
Country : US
Telephone Number : 267-639-1328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2019
Last Update Date : 04/29/2019

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