Provider Demographics
NPI:1376737379
Name:MARSHALL, LYNN ROQUEMORE (LPC-S)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ROQUEMORE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 REDWOOD PL
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-3319
Mailing Address - Country:US
Mailing Address - Phone:972-322-9000
Mailing Address - Fax:
Practice Address - Street 1:1400 N CORINTH ST STE 109
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76208-5444
Practice Address - Country:US
Practice Address - Phone:972-322-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-02
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005996101YP2500X
TX62684101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional