Provider Demographics
NPI:1336998764
Name:MILLS-MARQUES, ALDA G (CPM)
Entity type:Individual
Prefix:
First Name:ALDA
Middle Name:G
Last Name:MILLS-MARQUES
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 DAWSON LN
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-9137
Mailing Address - Country:US
Mailing Address - Phone:801-750-4575
Mailing Address - Fax:435-579-4308
Practice Address - Street 1:274 DAWSON LN
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-9137
Practice Address - Country:US
Practice Address - Phone:801-750-4575
Practice Address - Fax:435-579-4308
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife