Provider Demographics
NPI:1992007652
Name:MARSHALL, JEAN-PIERRE (BS)
Entity Type:Individual
Prefix:
First Name:JEAN-PIERRE
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8454 LOXTON CELLARS ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-7159
Mailing Address - Country:US
Mailing Address - Phone:662-251-2407
Mailing Address - Fax:
Practice Address - Street 1:8454 LOXTON CELLARS ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-7159
Practice Address - Country:US
Practice Address - Phone:662-251-2407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2103320828103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst