Provider Demographics
NPI:1265214373
Name:MARSH, CHARRISSE YVETTE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:CHARRISSE
Middle Name:YVETTE
Last Name:MARSH
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 NOBEL EARL CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3157
Mailing Address - Country:US
Mailing Address - Phone:832-808-7364
Mailing Address - Fax:
Practice Address - Street 1:5410 NOBEL EARL CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-3157
Practice Address - Country:US
Practice Address - Phone:832-808-7364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist