Provider Demographics
NPI:1134400104
Name:MARSHALL, CHRISTA M (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHRISTA
Middle Name:M
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 1:7427 BROOK RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1816
Mailing Address - Country:US
Mailing Address - Phone:804-482-0744
Mailing Address - Fax:888-972-4540
Practice Address - Street 1:7427 BROOK RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1816
Practice Address - Country:US
Practice Address - Phone:804-482-0744
Practice Address - Fax:888-972-4540
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004684103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical