Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 2958 | CT |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 2958 | CT |
NPI | 1134351885 |
---|---|
Provider Name | Dr. Nicole Sirrine Marshall |
First Address | Farmington, CT 06032-1499 |
Second Address | Farmington, CT 06032-1499 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2009 |
Last Update Date | 04/08/2017 |