Provider Demographics
NPI:1588943054
Name:MARQUEZ, ESPERANZA D (LPCC)
Entity type:Individual
Prefix:MS
First Name:ESPERANZA
Middle Name:D
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 CARLISLE BLVD NE STE Q
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-4544
Mailing Address - Country:US
Mailing Address - Phone:505-604-2633
Mailing Address - Fax:
Practice Address - Street 1:4004 CARLISLE BLVD NE STE Q
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4544
Practice Address - Country:US
Practice Address - Phone:505-604-2633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0148711101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional