Healthcare Provider Details

I. General information

NPI: 1558225243
Provider Name (Legal Business Name): CASSANDRA MARSHALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233A SHELBURNE RD
SOUTH BURLINGTON VT
05403-7712
US

IV. Provider business mailing address

101 OAKWOOD DR
SOUTH BURLINGTON VT
05403-6245
US

V. Phone/Fax

Practice location:
  • Phone: 719-640-9738
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: