Individual
MR. JEFFREY TONKINS MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
5749 RUTH DR, CHARLOTTE, NC 28215-2231
(704) 763-0687
Mailing address
5749 RUTH DR, CHARLOTTE, NC 28215-2231
(704) 763-0687
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1663
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107028
—
NC
Enumeration date
03/14/2007
Last updated
05/28/2013
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