Healthcare Provider Details

I. General information

NPI: 1043164924
Provider Name (Legal Business Name): ABBY MARSHALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 03/01/2026
Certification Date: 03/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2389 WOOSTER RD
ROCKY RIVER OH
44116-2747
US

IV. Provider business mailing address

2389 WOOSTER RD
ROCKY RIVER OH
44116-2747
US

V. Phone/Fax

Practice location:
  • Phone: 740-624-5933
  • Fax:
Mailing address:
  • Phone: 740-624-5933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2507666
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: