MEDICARE: MRS. ADRIENNE NICOLE MARSHALL LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	202466	TX

General Provider Information

NPI Number	:	1184133233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ADRIENNE NICOLE MARSHALL LMFT

Provider Business Mailing Address
First Line	:	4305 NAPA VALLEY DR
Second Line	:
City	:	ARGYLE
State	:	TX
Zip	:	76226-2299
Country	:	US
Telephone Number	:	817-929-2357
Fax Number	:

Provider Business Practice Location Address
First Line	:	9800 HILLWOOD PKWY STE 140
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-1532
Country	:	US
Telephone Number	:	682-231-3857
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2017
Last Update Date	:	09/20/2017

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