Provider Demographics
NPI:1366160913
Name:REYES MARQUEZ, STEPHANIE ANDREINA
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANDREINA
Last Name:REYES MARQUEZ
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 1:9817 MOCKINGBIRD HILL LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-3049
Mailing Address - Country:US
Mailing Address - Phone:832-270-1893
Mailing Address - Fax:
Practice Address - Street 1:2000 NORTH LOOP W STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8104
Practice Address - Country:US
Practice Address - Phone:832-413-2410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional