Provider Demographics
NPI:1194854083
Name:MARSHALL JENKINS, ESHA MASIKA (BS)
Entity Type:Individual
Prefix:
First Name:ESHA
Middle Name:MASIKA
Last Name:MARSHALL JENKINS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:ESHA
Other - Middle Name:MASIKA
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:911 173RD ST
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-2703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8400 LOUISIANA ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6385
Practice Address - Country:US
Practice Address - Phone:219-757-1928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor