Provider Demographics
NPI:1528792025
Name:QUINTERO, MARILYN ARECHIGA (LAPC)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:ARECHIGA
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 30TH AVE S STE 208
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-5054
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5354 42ND ST S STE B
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4032
Practice Address - Country:US
Practice Address - Phone:701-501-8014
Practice Address - Fax:701-941-4504
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ND13401-1-24A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program