Provider Demographics
NPI:1720489883
Name:HANSON-GROTZ, MARSHALEE LATOYA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARSHALEE
Middle Name:LATOYA
Last Name:HANSON-GROTZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 MIDDLETOWN BLVD. ST. 710
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-3503
Mailing Address - Country:US
Mailing Address - Phone:267-242-9819
Mailing Address - Fax:
Practice Address - Street 1:380 MIDDLETOWN BLVD. ST. 710
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-3503
Practice Address - Country:US
Practice Address - Phone:267-242-9819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006926101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional