Provider Demographics
NPI:1225378367
Name:DEAN, MARQUE-ANNE (LMT)
Entity Type:Individual
Prefix:MS
First Name:MARQUE-ANNE
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7656 JEFFERSON HWY
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1389
Mailing Address - Country:US
Mailing Address - Phone:225-928-8686
Mailing Address - Fax:225-928-8485
Practice Address - Street 1:7656 JEFFERSON HWY
Practice Address - Street 2:SUITE 1A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1389
Practice Address - Country:US
Practice Address - Phone:225-928-8686
Practice Address - Fax:225-928-8485
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA5620225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist