Provider Demographics
NPI:1699928002
Name:MARQUEZ, AMELIA MARIA (LISW 1-0916)
Entity type:Individual
Prefix:MS
First Name:AMELIA
Middle Name:MARIA
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:LISW 1-0916
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 LOPEZ STREET
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:82201
Mailing Address - Country:US
Mailing Address - Phone:505-425-8559
Mailing Address - Fax:
Practice Address - Street 1:2007 LOPEZ STREET
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701
Practice Address - Country:US
Practice Address - Phone:505-452-8559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker