Provider Demographics
NPI:1770021347
Name:MARQUEZ, MARIA GABRIELA (PSYD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:GABRIELA
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CUPEY GARDEN PLAZA 200 URB CUPEY GARDEN
Mailing Address - Street 2:SERVICIOS PSICOLOGICOS RAIGAMBRE
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-292-0205
Mailing Address - Fax:
Practice Address - Street 1:3 CUPEY GARDEN PLAZA 200 URB CUPEY GARDEN
Practice Address - Street 2:SERVICIOS PSICOLOGICOS RAIGAMBRE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-292-0205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5687103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical