Provider Demographics
NPI:1760262828
Name:MARSHALL, BRITTANY (PSYD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 GOLDEN GATE DR
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-2837
Mailing Address - Country:US
Mailing Address - Phone:402-614-0175
Mailing Address - Fax:
Practice Address - Street 1:1237 GOLDEN GATE DR
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2837
Practice Address - Country:US
Practice Address - Phone:402-614-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1113103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist