Provider Demographics
NPI:1003290172
Name:MARQUEZ-MARTINEZ, VIVINET Y (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:VIVINET
Middle Name:Y
Last Name:MARQUEZ-MARTINEZ
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 EASY ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-5903
Mailing Address - Country:US
Mailing Address - Phone:360-525-1990
Mailing Address - Fax:
Practice Address - Street 1:125 EASY ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-5903
Practice Address - Country:US
Practice Address - Phone:360-525-1990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABA61231380103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst