Individual
DR. CHARISSE EUDELLA MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DSW
Contact information
Practice address
25 W 132ND ST APT 10M, NEW YORK, NY 10037-3205
(917) 689-6795
Mailing address
25 W 132ND ST APT 10M, NEW YORK, NY 10037-3205
(917) 689-6795
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
062663
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
824142206
NEW YORK STATE DRIVERS LICENSE
NY
Enumeration date
07/27/2021
Last updated
07/27/2021
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