Individual
JESSICA MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
43 W BROAD ST, PAWCATUCK, CT 06379-1637
(860) 857-2834
Mailing address
2 MARION ST, WESTERLY, RI 02891-1712
(283) 486-0857
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001291
CT LICENSE
CT
01
—
COP00771
RI LICENSE
RI
Enumeration date
03/25/2014
Last updated
08/02/2021
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