Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 05077 | MD |
Y | 103T00000X | Psychologist | 05077 | MD |
N | 102L00000X | Psychologist | 0810005095 | VA |
N | 103T00000X | Psychologist | 0810005095 | VA |
N | 102L00000X | Psychologist | PS018487 | PA |
N | 103T00000X | Psychologist | PS018487 | PA |
N | 102L00000X | Psychologist | PSY1000938 | DC |
N | 103T00000X | Psychologist | PSY1000938 | DC |
N | 103G00000X | Clinical Psychologist | 05077 | MD |
N | 103TC0700X | Clinical Psychologist | 05077 | MD |
N | 103G00000X | Clinical Psychologist | 0810005095 | VA |
N | 103TC0700X | Clinical Psychologist | 0810005095 | VA |
N | 103G00000X | Clinical Psychologist | PS018487 | PA |
N | 103TC0700X | Clinical Psychologist | PS018487 | PA |
N | 103G00000X | Clinical Psychologist | PSY1000938 | DC |
N | 103TC0700X | Clinical Psychologist | PSY1000938 | DC |
NPI | 1013173525 |
---|---|
Provider Name | Dr. Lafaye F Marshall |
First Address | Annapolis, MD 21401-3271 |
Second Address | Annapolis, MD 21401-3271 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 14/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
066736600 | (05) | MD |