Individual
MARQUISHA KIMBROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
8500 N STEMMONS FWY STE 3052, DALLAS, TX 75247-3969
(214) 534-8479
Mailing address
8500 N STEMMONS FWY STE 3052, DALLAS, TX 75247-3969
(214) 534-8479
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06181988
IRS EIN
TX
Enumeration date
04/08/2020
Last updated
04/08/2020
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