Doctor Name: | MS. MARY MARSH |
NPI Number: | 1154750404 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSWA |
License Number: | P008468 |
Business Practice Address: | 1917 W Park Dr # A North Wilkesboro, NC - 286593585 |
Business Phone Number: | 3369036814 |
Business Fax Number: | 3366674457 |
Mailing Address: | Po Box 680427, CHARLOTTE |
State: | NC |
Postal Code: | 282160008 |
Phone Number: | 3369036814 |
Fax Number: | 3366674457 |
NPI Enumeration Date: | 11/07/2013 |
NPI Last Update Date: | 11/07/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | P008468 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |