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Individual

MATTHEW MARSHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NMT-C

Contact information

Practice address
2340 HAMPTON AVE, SAINT LOUIS, MO 63139-2935
(314) 647-2200
(314) 647-4172
Mailing address
9063 BURTON AVE, OVERLAND, MO 63114-4825
(314) 409-0421

Taxonomy

Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
167G00000X
Licensed Psychiatric Technician
MO
246Y00000X
Health Information Specialist/Technologist
MO

Other

Enumeration date
01/23/2018
Last updated
09/17/2021
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