Provider Demographics
NPI:1568175883
Name:MARSHALL, DOREEN SCHULTZ
Entity Type:Individual
Prefix:DR
First Name:DOREEN
Middle Name:SCHULTZ
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 ROSE RDG
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-4080
Mailing Address - Country:US
Mailing Address - Phone:404-357-3464
Mailing Address - Fax:
Practice Address - Street 1:3400 ROSE RDG
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30340-4080
Practice Address - Country:US
Practice Address - Phone:404-357-3464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist