Provider Demographics
NPI:1912630260
Name:MARQUEZ, JOSELINE (BCBA)
Entity type:Individual
Prefix:
First Name:JOSELINE
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8354 RUTHERFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459-2358
Mailing Address - Country:US
Mailing Address - Phone:773-787-6639
Mailing Address - Fax:
Practice Address - Street 1:8354 RUTHERFORD AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-2358
Practice Address - Country:US
Practice Address - Phone:773-787-6639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106E00000X
IL1-24-75250103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst