Provider Demographics
NPI:1972230464
Name:MARSHALL, ANNA (BCCHHP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:BCCHHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4068 CLINTONVIEW CT
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62226-7819
Mailing Address - Country:US
Mailing Address - Phone:618-381-8387
Mailing Address - Fax:
Practice Address - Street 1:4068 CLINTONVIEW CT
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-7819
Practice Address - Country:US
Practice Address - Phone:618-381-8387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor