Provider Demographics
NPI:1154634749
Name:MERKISON, MARQUITTA BREANNA (AUD)
Entity Type:Individual
Prefix:
First Name:MARQUITTA
Middle Name:BREANNA
Last Name:MERKISON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 M ST NW
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1434
Mailing Address - Country:US
Mailing Address - Phone:202-741-3275
Mailing Address - Fax:202-741-3277
Practice Address - Street 1:2300 M ST NW
Practice Address - Street 2:4TH FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1434
Practice Address - Country:US
Practice Address - Phone:202-741-3275
Practice Address - Fax:202-741-3277
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAUD0000112231H00000X
MD01201231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist