Provider Demographics
NPI:1386957355
Name:MARSH, TRUDI LYNN (MSW, LMSW)
Entity type:Individual
Prefix:
First Name:TRUDI
Middle Name:LYNN
Last Name:MARSH
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:TRUDI
Other - Middle Name:LYNN
Other - Last Name:BENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:1035 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2929
Mailing Address - Country:US
Mailing Address - Phone:989-736-8157
Mailing Address - Fax:989-358-3762
Practice Address - Street 1:51 N BARLOW RD
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:MI
Practice Address - Zip Code:48740-9606
Practice Address - Country:US
Practice Address - Phone:989-736-8157
Practice Address - Fax:989-358-3762
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010918421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical