Provider Demographics
NPI:1093196107
Name:MORGAN, MARQUISE
Entity Type:Individual
Prefix:
First Name:MARQUISE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 POYDRAS ST
Mailing Address - Street 2:APT 2513
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7579
Mailing Address - Country:US
Mailing Address - Phone:504-939-9337
Mailing Address - Fax:
Practice Address - Street 1:2651 POYDRAS ST
Practice Address - Street 2:APT 2513
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7579
Practice Address - Country:US
Practice Address - Phone:504-939-9337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12389104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker