Provider Demographics
NPI:1508366865
Name:MARSH, DAVID F
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:MARSH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 W BURNHAM ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68522-2118
Mailing Address - Country:US
Mailing Address - Phone:402-436-1927
Mailing Address - Fax:402-458-3290
Practice Address - Street 1:865 W BURNHAM ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-2118
Practice Address - Country:US
Practice Address - Phone:402-436-1927
Practice Address - Fax:402-458-3290
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE333101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health