Individual
BONNIE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
121 N WAYNE AVE, WAYNE, PA 19087-3542
(610) 574-0597
Mailing address
121 N WAYNE AVE, WAYNE, PA 19087-3542
(610) 574-0597
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC001959
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2321658000
IBC
PA
01
—
470829000
KEYSTONE
PA
01
—
7435476
AETNA
PA
Enumeration date
09/02/2006
Last updated
12/28/2012
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