Provider Demographics
NPI:1336271907
Name:MARQUART, JO ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JO
Middle Name:ANN
Last Name:MARQUART
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:TX
Mailing Address - Zip Code:79225-0425
Mailing Address - Country:US
Mailing Address - Phone:940-839-5414
Mailing Address - Fax:
Practice Address - Street 1:436 AVENUE I SOUTH
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:TX
Practice Address - Zip Code:79225-0425
Practice Address - Country:US
Practice Address - Phone:940-839-5414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical