Provider Demographics
NPI:1053004275
Name:MARQUIS, SHEENA JEANETTE
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:JEANETTE
Last Name:MARQUIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 MEYERWOOD LN S
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-7313
Mailing Address - Country:US
Mailing Address - Phone:817-630-1273
Mailing Address - Fax:
Practice Address - Street 1:1709 MEYERWOOD LN S
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-7313
Practice Address - Country:US
Practice Address - Phone:817-630-1273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104369104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker