Provider Demographics
NPI:1578818654
Name:MARQUIS, NATALIE (BCBA)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:MARQUIS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10425 SW 139TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-3174
Mailing Address - Country:US
Mailing Address - Phone:786-342-3333
Mailing Address - Fax:786-342-3333
Practice Address - Street 1:10425 SW 139TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-3174
Practice Address - Country:US
Practice Address - Phone:786-342-3333
Practice Address - Fax:786-342-3333
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1578818654Medicaid