Provider Demographics
NPI:1568257558
Name:MARSHALL, NIELA ME
Entity type:Individual
Prefix:
First Name:NIELA
Middle Name:ME
Last Name:MARSHALL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:NIELA
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1111 E AVENUE J7
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-4397
Mailing Address - Country:US
Mailing Address - Phone:702-335-9382
Mailing Address - Fax:
Practice Address - Street 1:1007 W AVENUE M14
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-1443
Practice Address - Country:US
Practice Address - Phone:661-947-9554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst