Provider Demographics
NPI:1356862601
Name:MARSHALL, DONNA M (PASTORAL COUNSELOR)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:M
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PASTORAL COUNSELOR
Other - Prefix:DR
Other - First Name:DONNA
Other - Middle Name:M
Other - Last Name:NOORALI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOCTOR IN DIVINITY
Mailing Address - Street 1:3298 SUMMIT BLVD STE 11
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-4350
Mailing Address - Country:US
Mailing Address - Phone:850-485-4899
Mailing Address - Fax:
Practice Address - Street 1:3298 SUMMIT BLVD STE 32
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-4332
Practice Address - Country:US
Practice Address - Phone:850-485-4899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
415370101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty