Provider Demographics
NPI:1003379876
Name:MARSHALL, MARSHE SHONA (AMFT)
Entity Type:Individual
Prefix:
First Name:MARSHE
Middle Name:SHONA
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14075 HESPERIA RD STE 105
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-4500
Mailing Address - Country:US
Mailing Address - Phone:760-964-7116
Mailing Address - Fax:
Practice Address - Street 1:14075 HESPERIA RD STE 105
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-4500
Practice Address - Country:US
Practice Address - Phone:760-964-7116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78101101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor