Individual
PHOENIX GRACE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4202 N INTERSTATE 10 SERVICE RD W, METARIE, LA 70006
(318) 751-3097
Mailing address
1437 NASHVILLE AVE, NEW ORLEANS, LA 70115-4349
(318) 751-3097
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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