Provider Demographics
NPI:1306943774
Name:MARCHEL, JAMES RUSSELL (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RUSSELL
Last Name:MARCHEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5674 HIGHLAND PARK CT
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-1200
Mailing Address - Country:US
Mailing Address - Phone:801-272-7639
Mailing Address - Fax:
Practice Address - Street 1:5674 HIGHLAND PARK CT
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-1200
Practice Address - Country:US
Practice Address - Phone:801-272-7639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2714922501103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist