Provider Demographics
NPI:1720787120
Name:MARROQUIN, LATRISHA (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:LATRISHA
Middle Name:
Last Name:MARROQUIN
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:DR
Other - First Name:TRISHA
Other - Middle Name:
Other - Last Name:MARROQUIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, LPC
Mailing Address - Street 1:10654 HUNTER DR
Mailing Address - Street 2:
Mailing Address - City:JUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:76247-7904
Mailing Address - Country:US
Mailing Address - Phone:817-308-8685
Mailing Address - Fax:
Practice Address - Street 1:1190 PARKER SQ APT SUITE
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-7432
Practice Address - Country:US
Practice Address - Phone:817-308-8685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty