Individual
MARSHA M KING-FAWCETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6910 HILLSDALE CT, INDIANAPOLIS, IN 46250-2040
(317) 621-7740
Mailing address
5480 WINTERHAZEL DR, INDIANAPOLIS, IN 46254-9634
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004474
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01751320
RAILROAD MEDICARE
IN
Enumeration date
06/25/2008
Last updated
04/07/2020
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