Basic Information
| Provider Information | |||||||||
| NPI: | 1366759987 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARSHALL | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | B.A. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 45 SUMMER ST | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014533228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784013952 | ||||||||
| FaxNumber: | 9785343294 | ||||||||
| Practice Location | |||||||||
| Address1: | 45 SUMMER ST | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 014533228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784013952 | ||||||||
| FaxNumber: | 9785343294 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2010 | ||||||||
| LastUpdateDate: | 09/02/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | MA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.