Provider Demographics
NPI:1689122079
Name:MARQUEZ, MARJORIE ISABEL (LMHC)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:ISABEL
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:ISABEL
Other - Last Name:PALACIOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:14261 SW 120TH ST STE 108-283
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7270
Mailing Address - Country:US
Mailing Address - Phone:786-519-0977
Mailing Address - Fax:
Practice Address - Street 1:14261 SW 120TH ST STE 108-283
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7270
Practice Address - Country:US
Practice Address - Phone:786-519-0977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12734101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health