Provider Demographics
NPI:1528579166
Name:MARQUES, LAURA MARIE (PHD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:MARQUES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 CANAL ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2703
Mailing Address - Country:US
Mailing Address - Phone:504-988-5246
Mailing Address - Fax:504-988-4270
Practice Address - Street 1:1440 CANAL ST STE 1000
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2703
Practice Address - Country:US
Practice Address - Phone:504-988-5405
Practice Address - Fax:504-988-4264
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1416103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist