Provider Demographics
NPI:1073540456
Name:MARSHALL, DEBORAH JOAN (MA, ATR-BC, LMHC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:JOAN
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MA, ATR-BC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BENNETT RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-2704
Mailing Address - Country:US
Mailing Address - Phone:508-358-2306
Mailing Address - Fax:508-358-2306
Practice Address - Street 1:10 BENNETT RD
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-2704
Practice Address - Country:US
Practice Address - Phone:508-358-2306
Practice Address - Fax:508-358-2306
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4328101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health