Individual
LYDIA GAYLE MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4521 COUNTY ROAD 200, CORINTH, MS 38834-7801
(662) 415-4249
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-319781
MS
Other
Enumeration date
03/01/2024
Last updated
03/01/2024
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