Provider Demographics
NPI:1316435183
Name:MARSH, CAMILLE ANN (LMHC)
Entity type:Individual
Prefix:MISS
First Name:CAMILLE
Middle Name:ANN
Last Name:MARSH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 W OAKLAND PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1600
Mailing Address - Country:US
Mailing Address - Phone:954-792-9241
Mailing Address - Fax:954-792-9243
Practice Address - Street 1:1061 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-1600
Practice Address - Country:US
Practice Address - Phone:954-792-9241
Practice Address - Fax:954-792-9243
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health