Individual
SHELLY MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSE
Contact information
Practice address
1516 ATWOOD AVE, JOHNSTON, RI 02919-3223
(401) 553-1000
(401) 722-5280
Mailing address
45 GREENWAY DR, BRISTOL, RI 02809-4209
(401) 862-4335
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GH57134
—
RI
Enumeration date
07/30/2012
Last updated
12/17/2014
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