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Individual

MR. SEAN TRAVIS MARSHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CSW

Contact information

Practice address
415 GIBSON LN, RICHMOND, KY 40475-2577
(859) 623-9367
(859) 623-9389
Mailing address
415 GIBSON LN, RICHMOND, KY 40475-2577
(859) 623-9367
(859) 623-9389

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7150
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790731081
KY
Enumeration date
03/03/2016
Last updated
05/16/2016
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