Individual
GWENNETH S MARSHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
820 CHICAGO BLVD, DETROIT, MI 48202-1417
(313) 999-0169
Mailing address
820 CHICAGO BLVD, DETROIT, MI 48202-1417
(313) 999-0169
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401011633
MI
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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