Individual
MICHELE MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 CHURCH ST, PHILADELPHIA, PA 19106-2201
(055) 026-7807
Mailing address
1708 65TH AVE, PHILADELPHIA, PA 19126-3412
(856) 343-2565
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
101YM0800X
NJ
Other
Enumeration date
06/30/2014
Last updated
07/25/2025
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