Individual
MR. TRACY LEE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LMFT
Contact information
Practice address
2153 E JOYCE BLVD, FAYETTEVILLE, AR 72703-4714
(479) 575-9741
Mailing address
2153 E JOYCE BLVD, FAYETTEVILLE, AR 72703-4714
(479) 575-9741
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0803029
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P0803029
LPC & LAMFT
AR
Enumeration date
07/14/2008
Last updated
09/12/2011
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