Provider Demographics
NPI:1255850624
Name:WOELFLE MARSHALL, SUSAN (COTA)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:WOELFLE MARSHALL
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 HAGUE RD
Mailing Address - Street 2:
Mailing Address - City:DUMMERSTON
Mailing Address - State:VT
Mailing Address - Zip Code:05301-9689
Mailing Address - Country:US
Mailing Address - Phone:646-938-5474
Mailing Address - Fax:
Practice Address - Street 1:167 MAIN ST STE 207
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-3096
Practice Address - Country:US
Practice Address - Phone:646-938-5474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-16
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical