Individual
DR. DUSTIN MARSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
19044 OUTER DR, DEARBORN, MI 48128
(213) 663-6862
Mailing address
19044 OUTER DR, DEARBORN, MI 48128-1862
(213) 663-6862
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
6301017547
MI
103TC0700X
Clinical Psychologist
Primary
6301018274
MI
172V00000X
Community Health Worker
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6301017547
LIMITED LICENSE PSYCHOLOGIST - DOCTORAL
MI
Enumeration date
01/07/2011
Last updated
03/11/2020
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