Provider Demographics
NPI:1447380845
Name:MARROQUIN, SONIA MARIE (OT)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:MARIE
Last Name:MARROQUIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4224 ORA ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-3427
Mailing Address - Country:US
Mailing Address - Phone:210-326-4781
Mailing Address - Fax:956-287-7401
Practice Address - Street 1:2421 SAN JOSE DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-0224
Practice Address - Country:US
Practice Address - Phone:210-326-4781
Practice Address - Fax:855-446-8079
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110927225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182957404Medicaid