Provider Demographics
NPI:1073567822
Name:PURVIS, MARSHA H (PHD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:H
Last Name:PURVIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2511 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-3153
Mailing Address - Country:US
Mailing Address - Phone:803-252-9457
Mailing Address - Fax:803-252-2645
Practice Address - Street 1:1816 BULL ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2506
Practice Address - Country:US
Practice Address - Phone:803-252-1095
Practice Address - Fax:803-252-2645
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1506106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist