MEDICARE: JAZMINE MARSHALL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	101YM0800X	Mental Health Counselor	TX
2	103K00000X	Behavior Analyst	TX
3	103TF0000X	Family Psychologist
4	104100000X	Social Worker	TX
5	106H00000X	Marriage & Family Therapist	TX
6	171400000X	Health & Wellness Coach	TX

General Provider Information

NPI Number	:	1578412102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAZMINE MARSHALL

Provider Business Mailing Address
First Line	:	15715 MUNSON LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77053-3530
Country	:	US
Telephone Number	:	346-276-3363
Fax Number	:

Provider Business Practice Location Address
First Line	:	15715 MUNSON LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77053-3530
Country	:	US
Telephone Number	:	346-276-3363
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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Directions to “ JAZMINE MARSHALL ” Practice Location

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