Provider Demographics
NPI:1902060403
Name:NEAL, MARQUITA (MA)
Entity type:Individual
Prefix:MS
First Name:MARQUITA
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1126 E VERNON RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-3126
Mailing Address - Country:US
Mailing Address - Phone:215-549-7977
Mailing Address - Fax:
Practice Address - Street 1:1126 E VERNON RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-3126
Practice Address - Country:US
Practice Address - Phone:215-549-7977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist