Provider Demographics
NPI:1780216259
Name:MARQUIS, KATRINA (PTA)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:MARQUIS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BILLINGS ST
Mailing Address - Street 2:
Mailing Address - City:LANESBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01237-9750
Mailing Address - Country:US
Mailing Address - Phone:413-281-7441
Mailing Address - Fax:
Practice Address - Street 1:101 STATE ST
Practice Address - Street 2:
Practice Address - City:KENNETH SQUARE
Practice Address - State:PA
Practice Address - Zip Code:10348
Practice Address - Country:US
Practice Address - Phone:610-444-6350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2084225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant