MEDICARE: FABIOLA I MARQUEZ

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
1	103TS0200X	School Psychologist		AZ

General Provider Information

NPI Number	:	1235069345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FABIOLA I MARQUEZ

Provider Business Mailing Address
First Line	:	4515 E PECAN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-4039
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4515 E PECAN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-4039
Country	:	US
Telephone Number	:	602-326-5962
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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Directions to “ FABIOLA I MARQUEZ ” Practice Location

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