Provider Demographics
NPI:1922346170
Name:WOOLEY, MARQUITA JENNINGS (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARQUITA
Middle Name:JENNINGS
Last Name:WOOLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20815 BLUE TRINITY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2296
Mailing Address - Country:US
Mailing Address - Phone:210-788-9190
Mailing Address - Fax:
Practice Address - Street 1:8930 FOURWINDS DR
Practice Address - Street 2:335
Practice Address - City:WINDCREST
Practice Address - State:TX
Practice Address - Zip Code:78239-1970
Practice Address - Country:US
Practice Address - Phone:210-473-4246
Practice Address - Fax:210-590-0355
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66550101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional