Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 35SI00463900 | NJ |
N | 103T00000X | Psychologist | 35SI00463900 | NJ |
N | 103TA0700X | Adult Development & Aging Psychologist | 35SI00463900 | NJ |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 35SI00463900 | NJ |
Y | 103G00000X | Clinical Psychologist | 35SI00463900 | NJ |
Y | 103TC0700X | Clinical Psychologist | 35SI00463900 | NJ |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 35SI00463900 | NJ |
N | 103TM1800X | Intellectual & Developmental Disabilities | 35SI00463900 | NJ |
N | 103TS0200X | School Psychologist | 35SI00463900 | NJ |
NPI | 1982885307 |
---|---|
Provider Name | Dr. Yahaira Ines Marquez |
First Address | Stratford, NJ 08084-1354 |
Second Address | Stratford, NJ 08084-1354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2007 |
Last Update Date | 24/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0167258 | (05) | NJ |