Provider Demographics
NPI:1073384327
Name:MARSHALL, MONICA (LMT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-4917
Mailing Address - Country:US
Mailing Address - Phone:330-928-2273
Mailing Address - Fax:330-922-4088
Practice Address - Street 1:1251 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-4917
Practice Address - Country:US
Practice Address - Phone:330-928-2273
Practice Address - Fax:330-922-4088
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.022506225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist