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Individual

MARSHA ANN FASULLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
433 METAIRIE RD, SUITE 106, METAIRIE, LA 70005-4333
(504) 835-5007
(504) 835-5018
Mailing address
314 CHERRY BLOSSOM LN, TERRYTOWN, LA 70056-2758
(504) 388-3258
(504) 263-1556

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1654
LA

Other

Enumeration date
11/30/2007
Last updated
11/30/2007
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