Provider Demographics
NPI:1982748711
Name:MARROQUIN, YVETTE MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:MARIE
Last Name:MARROQUIN
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 1:13610 BENTWOOD OAKS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3507
Mailing Address - Country:US
Mailing Address - Phone:210-313-4007
Mailing Address - Fax:
Practice Address - Street 1:6487 WHITBY RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-2131
Practice Address - Country:US
Practice Address - Phone:210-313-4007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX180631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1012148Medicaid
TX610502Medicare ID - Type UnspecifiedLCSW