Provider Demographics
NPI:1831346444
Name:MARSHEL, CLAIRE WASKOM
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:WASKOM
Last Name:MARSHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:A
Other - Last Name:WASKOM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, ATR
Mailing Address - Street 1:147 W OAK ST STE 113
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-7124
Mailing Address - Country:US
Mailing Address - Phone:970-482-5112
Mailing Address - Fax:
Practice Address - Street 1:147 W OAK ST STE 113
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-7124
Practice Address - Country:US
Practice Address - Phone:970-482-5112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4466101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional