Doctor Name: | MS. KYSHEENNA SHERRELL MARSHALL |
NPI Number: | 1417186289 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 53120 |
Business Practice Address: | 12223 Spring Branch Dr Balch Springs, TX - 751802943 |
Business Phone Number: | 2142643564 |
Business Fax Number: | |
Mailing Address: | 12223 Spring Branch Dr, BALCH SPRINGS |
State: | TX |
Postal Code: | 751802943 |
Phone Number: | 2142643564 |
Fax Number: | |
NPI Enumeration Date: | 07/14/2009 |
NPI Last Update Date: | 07/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 53120 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |