| Doctor Name: | DR. URSULA WIESE MARSH |
| NPI Number: | 1114164977 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 2007036957 |
| Business Practice Address: | 219 Creekside Office Drive Wentzville, MO - 633853290 |
| Business Phone Number: | 6363570136 |
| Business Fax Number: | 6366391004 |
| Mailing Address: | 7 Country Rd, P.o. Box 186 FORISTELL |
| State: | MO |
| Postal Code: | 633481722 |
| Phone Number: | 6363326906 |
| Fax Number: | 6366391004 |
| NPI Enumeration Date: | 01/15/2009 |
| NPI Last Update Date: | 11/17/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2007036957 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |