MEDICARE: MAGGIE MARSHALL

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	235Z00000X	Speech-Language Pathologist	22006181A	IN

General Provider Information

NPI Number	:	1184303844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAGGIE MARSHALL

Provider Business Mailing Address
First Line	:	2932 CHESTNUT EAGLE RDG
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-7632
Country	:	US
Telephone Number	:	812-225-6080
Fax Number	:

Provider Business Practice Location Address
First Line	:	2932 CHESTNUT EAGLE RDG
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-7632
Country	:	US
Telephone Number	:	812-225-6080
Fax Number	:

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

Provider Enumeration Date	:	07/11/2023
Last Update Date	:	07/11/2023

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Directions to “ MAGGIE MARSHALL ” Practice Location

Language	Start Address	Practice Location

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