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Individual

MADISON R MARSHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCMHCA

Contact information

Practice address
1806 S 15TH ST, WILMINGTON, NC 28401-6479
(910) 772-2515
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A19385
NC
101YP2500X
Professional Counselor
Primary
A19385
NC

Other

Enumeration date
01/20/2022
Last updated
03/13/2024
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