Provider Demographics
NPI:1841010733
Name:MARQUES, MIRANDA LEIGH (MSW)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:LEIGH
Last Name:MARQUES
Suffix:
Gender:X
Credentials:MSW
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:
Other - Last Name:MARQUES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:4055 MONROEVILLE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2522
Mailing Address - Country:US
Mailing Address - Phone:412-414-9916
Mailing Address - Fax:
Practice Address - Street 1:4055 MONROEVILLE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2522
Practice Address - Country:US
Practice Address - Phone:412-414-9916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker