Provider Demographics
NPI:1427647916
Name:MARQUEZ-VILLEGAS, JUANA IRIS (MENTAL HEALTH COUNSE)
Entity type:Individual
Prefix:
First Name:JUANA
Middle Name:IRIS
Last Name:MARQUEZ-VILLEGAS
Suffix:
Gender:F
Credentials:MENTAL HEALTH COUNSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 18TH ST NW # NA
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1812
Mailing Address - Country:US
Mailing Address - Phone:202-673-7308
Mailing Address - Fax:
Practice Address - Street 1:2201 18TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1812
Practice Address - Country:US
Practice Address - Phone:202-673-7308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000Other00000