Individual
DR. MARY MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
406 W 34TH ST # 501, KANSAS CITY, MO 64111-2778
(913) 735-9931
Mailing address
2221 W 124TH ST, LEAWOOD, KS 66209-1305
(913) 735-9931
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0089
KS
103G00000X
Clinical Neuropsychologist
00376
MO
103T00000X
Psychologist
00376
MO
103TC0700X
Clinical Psychologist
Primary
1328
KS
103TH0004X
Health Psychologist
00376
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
496729120
—
MO
Enumeration date
01/31/2007
Last updated
08/20/2015
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