Provider Demographics
NPI:1558621201
Name:MARSHALL, DANIELLE LAURIE (MA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LAURIE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 W HILL RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NH
Mailing Address - Zip Code:03465-2620
Mailing Address - Country:US
Mailing Address - Phone:603-593-2022
Mailing Address - Fax:
Practice Address - Street 1:491 MAIN ST
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-1846
Practice Address - Country:US
Practice Address - Phone:978-249-9926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)