| Doctor Name: | BROOKE RENAE MARSHALL |
| NPI Number: | 1528458254 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | 6802088303 |
| Business Practice Address: | 1040 S Winter St Suite 1022 Adrian, MI - 492213876 |
| Business Phone Number: | 5172638905 |
| Business Fax Number: | 5172658237 |
| Mailing Address: | 426 Jackson St, PETOSKEY |
| State: | MI |
| Postal Code: | 497702218 |
| Phone Number: | 2318818351 |
| Fax Number: | |
| NPI Enumeration Date: | 02/03/2015 |
| NPI Last Update Date: | 02/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 6802088303 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |