Provider Demographics
NPI:1669686457
Name:MARQUEZ-GREENE, NELBA L (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:NELBA
Middle Name:L
Last Name:MARQUEZ-GREENE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 NEW BRITAIN AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-4033
Mailing Address - Country:US
Mailing Address - Phone:860-833-5430
Mailing Address - Fax:860-953-1081
Practice Address - Street 1:602 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-4033
Practice Address - Country:US
Practice Address - Phone:860-833-5430
Practice Address - Fax:860-953-1081
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001209106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist