Healthcare Provider Details

I. General information

NPI: 1588616361
Provider Name (Legal Business Name): MARSHA L CASKY M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 06/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 BARNES RD
WILLIAMSTOWN KY
41097-9483
US

IV. Provider business mailing address

502 FARRELL DR
COVINGTON KY
41011-3717
US

V. Phone/Fax

Practice location:
  • Phone: 859-331-3292
  • Fax: 859-578-2864
Mailing address:
  • Phone: 859-578-3204
  • Fax: 859-578-3273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number138963
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: