Provider Demographics
NPI:1285474486
Name:MARSHALSEA, MARISSA LYNNE
Entity type:Individual
Prefix:MRS
First Name:MARISSA
Middle Name:LYNNE
Last Name:MARSHALSEA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 ROYALSTON RD
Mailing Address - Street 2:
Mailing Address - City:FITZWILLIAM
Mailing Address - State:NH
Mailing Address - Zip Code:03447-3435
Mailing Address - Country:US
Mailing Address - Phone:978-987-2825
Mailing Address - Fax:
Practice Address - Street 1:16 TOWN CRIER DR
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-8669
Practice Address - Country:US
Practice Address - Phone:802-258-4623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)