Provider Demographics
NPI:1962154799
Name:MCCALL, MARQUISHA A
Entity type:Individual
Prefix:MRS
First Name:MARQUISHA
Middle Name:A
Last Name:MCCALL
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 1:12500 DUNLAP ST APT 379
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-5332
Mailing Address - Country:US
Mailing Address - Phone:346-290-0920
Mailing Address - Fax:
Practice Address - Street 1:12500 DUNLAP ST APT 379
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-5332
Practice Address - Country:US
Practice Address - Phone:346-290-0920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-23
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician