Provider Demographics
NPI:1902153166
Name:RICE, MARQUECIA A (MED)
Entity Type:Individual
Prefix:MRS
First Name:MARQUECIA
Middle Name:A
Last Name:RICE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15013 N 251 RD
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-2186
Mailing Address - Country:US
Mailing Address - Phone:918-829-5558
Mailing Address - Fax:
Practice Address - Street 1:15013 N 251 RD
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-2186
Practice Address - Country:US
Practice Address - Phone:918-829-5558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health