Provider Demographics
NPI:1033314018
Name:MARSHAL, MICHAEL P (PHD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:MARSHAL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SHADY AVE STE A205
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4450
Mailing Address - Country:US
Mailing Address - Phone:412-616-3432
Mailing Address - Fax:
Practice Address - Street 1:401 SHADY AVE STE A205
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4450
Practice Address - Country:US
Practice Address - Phone:412-616-3432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016055103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent