Provider Demographics
NPI:1306402839
Name:MICHELLE MARSHALL PSYCHIATRY SERVICES, PLLC
Entity Type:Organization
Organization Name:MICHELLE MARSHALL PSYCHIATRY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:512-454-5716
Mailing Address - Street 1:3305 NORTHLAND DR STE 210
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4988
Mailing Address - Country:US
Mailing Address - Phone:512-454-5716
Mailing Address - Fax:512-454-6276
Practice Address - Street 1:3305 NORTHLAND DR STE 210
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4988
Practice Address - Country:US
Practice Address - Phone:585-329-5559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health