MEDICARE: MARSHNEIL LAL

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1194189506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARSHNEIL LAL

Provider Business Mailing Address
First Line	:	3039 W PEORIA AVE SUITE 102 BOX 427
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-5212
Country	:	US
Telephone Number	:	480-993-5431
Fax Number	:	480-914-1366

Provider Business Practice Location Address
First Line	:	3039 W PEORIA AVE STE 102
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-5212
Country	:	US
Telephone Number	:	480-993-5431
Fax Number	:	480-914-1366

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

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	03/24/2026

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Directions to “ MARSHNEIL LAL ” Practice Location

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