Most Relevant Information
Provider Data
| NPI Number: | 1003079039 |
| Provider Name: | MARY MARSHALL FAODP |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 820317 |
Most Important Dates
| Enumeration Date: | 07/09/2008 |
| Last Updated: | 07/09/2008 |
Provider Practice Location
91 GLENDALE ST
HIGHLAND PARK
MI
482033274
Practice Location Phone/Fax
| Phone: | 3132630077 |
| Fax: | 3138830442 |
Provider Mailing Location
91 GLENDALE ST
HIGHLAND PARK
MI
482033274
Provider Mailing Phone/Fax
| Phone: | 3132630077 |
| Fax: | 3138830442 |