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General NPI Number Information
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NPI Number | 1265058382
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Entity Type | Organization
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Legal Business Name | MARTA MARSHALL PA
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Dates
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Enumeration Date | 06/24/2020
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Last Update Date | 06/24/2020
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Provider Practice Location Address
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Address Line | 3802 EHRLICH RD STE 101
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City | TAMPA
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State | FL
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Zip | 33624-2330
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Country | US
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Telephone | 813-908-2228
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Fax |
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Provider Business Mailing Address
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Address Line | 6117 GENTLE BEN CIR
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-3440
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Country | US
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Telephone | 813-541-5735
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MARTA MARSHALL
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Credential | LMHC
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Telephone | 813-541-5735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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