Provider Demographics
NPI:1447056882
Name:BLAKENEY, MARQUITA (BT)
Entity type:Individual
Prefix:
First Name:MARQUITA
Middle Name:
Last Name:BLAKENEY
Suffix:
Gender:
Credentials:BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 W ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:PAGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29728-7478
Mailing Address - Country:US
Mailing Address - Phone:843-672-4561
Mailing Address - Fax:
Practice Address - Street 1:930 W ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:PAGELAND
Practice Address - State:SC
Practice Address - Zip Code:29728-7478
Practice Address - Country:US
Practice Address - Phone:843-672-4561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician