Provider Demographics
NPI:1992008338
Name:MCKIRACHAN, JOAN MARQUIS
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:MARQUIS
Last Name:MCKIRACHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 POST OAK PLACE DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3164
Mailing Address - Country:US
Mailing Address - Phone:713-465-5072
Mailing Address - Fax:713-465-0422
Practice Address - Street 1:4545 POST OAK PLACE DR
Practice Address - Street 2:SUITE 303
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3164
Practice Address - Country:US
Practice Address - Phone:713-465-5072
Practice Address - Fax:713-465-0422
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5096101YP2500X
TX705106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional