Provider Information for 1174943419
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RAE MARIE MARSH LCSW
Sex: Female
NPI: 1174943419
Last Updated: 2021-08-16
Certification Date: 2021-08-16
Certification Date: 2021-08-16
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1174943419 | ||||||||||||
| Enumeration Date | 2014-04-25 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2538 GREAT DAISY LN NEW HILL, NC 27562-9353 United States Phone: 919-438-0837 | Fax: | ||||||||||||
| Primary Practice Address | 2538 GREAT DAISY LN NEW HILL, NC 27562-9353 United States Phone: 919-438-0837 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 202 PRIVATE COOPER LN APT 2C | ||||||||||||
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