MEDICARE: CASSANDRA MARSHALL LMSW

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1366874455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA MARSHALL LMSW

Provider Business Mailing Address
First Line	:	277 GRATIOT AVE
Second Line	:	STE 511
City	:	DETROIT
State	:	MI
Zip	:	48226-2239
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	277 GRATIOT AVE
Second Line	:	STE 511
City	:	DETROIT
State	:	MI
Zip	:	48226-2239
Country	:	US
Telephone Number	:	586-382-2632
Fax Number	:

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

Provider Enumeration Date	:	07/31/2013
Last Update Date	:	07/31/2013

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Directions to “ CASSANDRA MARSHALL LMSW” Practice Location

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