Provider Demographics
NPI:1740912401
Name:MARCOUX, TRISHA (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:MARCOUX
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 MORRIS PL APT 1
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3768
Mailing Address - Country:US
Mailing Address - Phone:207-240-8506
Mailing Address - Fax:
Practice Address - Street 1:57 MORRIS PL APT 1
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3768
Practice Address - Country:US
Practice Address - Phone:207-240-8506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00977800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist