Provider Demographics
NPI:1902464407
Name:MARSHALL, SHENIQUA (MASTER HERBALIST)
Entity type:Individual
Prefix:
First Name:SHENIQUA
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MASTER HERBALIST
Other - Prefix:
Other - First Name:GODIS
Other - Middle Name:
Other - Last Name:AUSET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:REIKI MASTER
Mailing Address - Street 1:3390 N LUMPKIN RD APT 4107
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31903-6606
Mailing Address - Country:US
Mailing Address - Phone:229-364-2721
Mailing Address - Fax:
Practice Address - Street 1:3390 N LUMPKIN RD APT 4107
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31903-6606
Practice Address - Country:US
Practice Address - Phone:229-364-2721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA106S00000X, 374K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician