Individual
NASTASSJA MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3111 NORTHSIDE AVE STE 101, RICHMOND, VA 23228-5441
(917) 753-7593
Mailing address
3003 PARKWOOD AVE APT 106, RICHMOND, VA 23221-3519
(917) 753-7593
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810005475
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2015
Last updated
09/11/2018
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