Provider Demographics
NPI:1427268861
Name:MILLER-MARSHALL, PATRICIA ANN (LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:MILLER-MARSHALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 CUMBERLAND ST
Mailing Address - Street 2:SUITE 16
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-5064
Mailing Address - Country:US
Mailing Address - Phone:501-366-3290
Mailing Address - Fax:
Practice Address - Street 1:1409 CUMBERLAND ST
Practice Address - Street 2:SUITE 16
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-5064
Practice Address - Country:US
Practice Address - Phone:501-366-3290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2122-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical