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General NPI Number Information
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NPI Number | 1720334600
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Entity Type | Individual
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Provider Name | SHELLY MARSHALL LCSE
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Gender | Female
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 1516 ATWOOD AVE
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City | JOHNSTON
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State | RI
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Zip | 02919-3223
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Country | US
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Telephone | 401-553-1000
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Fax | 401-722-5280
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Provider Business Mailing Address
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Address Line | 45 GREENWAY DR
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City | BRISTOL
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State | RI
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Zip | 02809-4209
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Country | US
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Telephone | 401-862-4335
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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