Provider Demographics
NPI:1447575345
Name:MARCHAND, MARY ANN (LMT)
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:MARCHAND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 W BEARSS AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1266
Mailing Address - Country:US
Mailing Address - Phone:813-960-8833
Mailing Address - Fax:
Practice Address - Street 1:326 W BEARSS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1266
Practice Address - Country:US
Practice Address - Phone:813-960-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 44144174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist