Provider Demographics
NPI:1437412459
Name:MARSHALL, NICHELE LYNNE (MS,TSHH)
Entity Type:Individual
Prefix:MRS
First Name:NICHELE
Middle Name:LYNNE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MS,TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 STATE ROUTE 13
Mailing Address - Street 2:
Mailing Address - City:NEW WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:13122-9746
Mailing Address - Country:US
Mailing Address - Phone:315-662-3237
Mailing Address - Fax:
Practice Address - Street 1:1844 STATE ROUTE 13
Practice Address - Street 2:
Practice Address - City:NEW WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:13122-9746
Practice Address - Country:US
Practice Address - Phone:315-662-3237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist