Provider Demographics
NPI:1598247397
Name:MARROQUIN, MONICA MARBELIA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:MARBELIA
Last Name:MARROQUIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5515 ARAPAHO RD APT 239
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-3707
Mailing Address - Country:US
Mailing Address - Phone:956-466-4734
Mailing Address - Fax:
Practice Address - Street 1:2700 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7524
Practice Address - Country:US
Practice Address - Phone:469-752-8240
Practice Address - Fax:469-752-8249
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX398502355S0801X
TX118684235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant