Organization
UPSTREAM NEUROPSYCHOLOGY & THERAPY SERVICES LLC
Active
Organization
UPSTREAM NEUROPSYCHOLOGY & THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DANIEL MARQUEZ PSY.D. (OWNER/NEUROPSYCHOLOGIST)
(505) 407-5852
Entity
Organization
Contact information
Practice address
210 N COURT AVE, FARMINGTON, NM 87401-6941
(505) 407-5852
Mailing address
210 N COURT AVE, FARMINGTON, NM 87401-6941
(505) 407-5852
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103TC0700X
Clinical Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
Other
Enumeration date
07/09/2026
Last updated
07/10/2026
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