Provider Demographics
NPI:1154915866
Name:MARROQUIN, MICHELE (STA)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:MARROQUIN
Suffix:
Gender:F
Credentials:STA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6906 AVENIDA DEL PASEO ST
Mailing Address - Street 2:
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78572-1879
Mailing Address - Country:US
Mailing Address - Phone:956-624-3171
Mailing Address - Fax:
Practice Address - Street 1:5215 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2202
Practice Address - Country:US
Practice Address - Phone:956-803-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX402112355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant