Provider Demographics
NPI:1902295728
Name:MARSHALL, STEPHANIE ANN (MS, S/T)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MS, S/T
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ANN
Other - Last Name:UHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9876 MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-3970
Mailing Address - Country:US
Mailing Address - Phone:770-516-1050
Mailing Address - Fax:770-516-1300
Practice Address - Street 1:9876 MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3970
Practice Address - Country:US
Practice Address - Phone:770-516-1050
Practice Address - Fax:770-516-1300
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-16
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor