Provider Demographics
NPI:1538608005
Name:MARQUIS, EMILY NICOLE (BCBA)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:NICOLE
Last Name:MARQUIS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:NICOLE
Other - Last Name:PHILLIPPI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:117 NEW YORK AVE NW UNIT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1229
Mailing Address - Country:US
Mailing Address - Phone:814-659-2949
Mailing Address - Fax:
Practice Address - Street 1:5272 RIVER RD
Practice Address - Street 2:#300
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-1405
Practice Address - Country:US
Practice Address - Phone:814-659-2949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000872103K00000X
MDLBA298103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst