Individual
MARTHA GRACE MARQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, MCAP
Contact information
Practice address
1881 NE 26TH ST STE 201A, WILTON MANORS, FL 33305
(965) 368-5819
(954) 530-1792
Mailing address
1881 NE 26TH ST STE 201A, WILTON MANORS, FL 33305-1427
(954) 368-5819
(954) 530-1792
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAP4063
FL
101YM0800X
Mental Health Counselor
MH8046
FL
101YP2500X
Professional Counselor
Primary
MH8046
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076576700
—
FL
Enumeration date
02/14/2007
Last updated
08/28/2018
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