Provider Demographics
NPI:1568981306
Name:MARSHALL, OLIVIAH SHELLY (LLBSW)
Entity Type:Individual
Prefix:
First Name:OLIVIAH
Middle Name:SHELLY
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LLBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22933 POWER RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336-4050
Mailing Address - Country:US
Mailing Address - Phone:248-835-9303
Mailing Address - Fax:
Practice Address - Street 1:24425 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-1616
Practice Address - Country:US
Practice Address - Phone:313-450-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner