Provider Demographics
NPI:1013153675
Name:MARSHALL, SARA H (PHD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:H
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1868 KAHAKAI DR
Mailing Address - Street 2:UNIT 112
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4838
Mailing Address - Country:US
Mailing Address - Phone:808-772-1162
Mailing Address - Fax:
Practice Address - Street 1:1868 KAHAKAI DR
Practice Address - Street 2:UNIT 112
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4838
Practice Address - Country:US
Practice Address - Phone:808-772-1162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000057801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB14866Medicare UPIN