Individual
JILLIAN M MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
115 N PARK TRL STE 101, STOCKBRIDGE, GA 30281-7373
(470) 491-2050
(470) 408-2371
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(866) 610-0580
(407) 588-6294
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
08/21/2017
Last updated
11/03/2022
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