Provider Demographics
NPI:1255573309
Name:M.R.Q. ASSOCIATES
Entity type:Organization
Organization Name:M.R.Q. ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHEREEMA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:215-921-0459
Mailing Address - Street 1:4414 GERMANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-1727
Mailing Address - Country:US
Mailing Address - Phone:215-921-0459
Mailing Address - Fax:215-745-2783
Practice Address - Street 1:4414 GERMANTOWN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-1727
Practice Address - Country:US
Practice Address - Phone:215-921-0459
Practice Address - Fax:215-745-2783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty