Individual
JACKIE DEE MARQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
219 N KING ST, ALICE, TX 78332-4841
(361) 664-4366
Mailing address
4614 STONEGATE WAY, CORPUS CHRISTI, TX 78411
(361) 658-7153
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209989
TX
Other
Enumeration date
09/03/2018
Last updated
09/03/2018
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