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General NPI Number Information
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NPI Number | 1396859310
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Entity Type | Individual
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Provider Name | MARSHA JEANNE FIELDS L. P.
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Gender | Female
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 12/15/2015
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Provider Practice Location Address
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Address Line | 1400 MADISON AVE SUITE 352
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City | MANKATO
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State | MN
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Zip | 56001-5473
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Country | US
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Telephone | 507-625-1811
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Fax |
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Provider Business Mailing Address
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Address Line | 1230 E MAIN ST PO BOX 8674
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City | MANKATO
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State | MN
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Zip | 56001-5066
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Country | US
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Telephone | 507-625-1811
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 2028
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4328
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2514-057
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2028
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 4328
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License Number State | MN
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Taxonomy #6
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 4328
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License Number State | MN
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Taxonomy #7
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | 4328
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License Number State | MN
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Taxonomy #8
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | 4328
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License Number State | MN
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