Individual
AYASHA NICHELLE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4929 W FOND DU LAC AVE, MILWAUKEE, WI 53216-2324
(414) 383-4486
(414) 871-2552
Mailing address
4929 W FOND DU LAC AVE, MILWAUKEE, WI 53216-2324
(414) 383-4486
(414) 871-2552
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6405893873
—
WI
Enumeration date
10/09/2019
Last updated
10/09/2019
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