Healthcare Provider Details

I. General information

NPI: 1497405690
Provider Name (Legal Business Name): SHELLINA MARSHALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1564 MCDANIEL DR
WEST CHESTER PA
19380-6672
US

IV. Provider business mailing address

1564 MCDANIEL DR
WEST CHESTER PA
19380-6672
US

V. Phone/Fax

Practice location:
  • Phone: 215-605-6608
  • Fax:
Mailing address:
  • Phone: 484-254-6559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: