Provider Demographics
NPI:1417000191
Name:MARSHALL, KATE MACQUEEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATE
Middle Name:MACQUEEN
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 ARNETT ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2401
Mailing Address - Country:US
Mailing Address - Phone:303-443-5811
Mailing Address - Fax:
Practice Address - Street 1:1517 EASY RIDER LN APT 201
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-8406
Practice Address - Country:US
Practice Address - Phone:303-443-5811
Practice Address - Fax:303-440-0152
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO795103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist