| Marshall Devolopmental Therapy Services Inc | |
|
308 Estes Mill Rd Walnut Grove MS 39189-5043 | |
| (317) 388-8131 | |
| Not Available |
| Full Name | Marshall Devolopmental Therapy Services Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 308 Estes Mill Rd, Walnut Grove, Mississippi |
| Authorized Official Name and Position | Angelica N Gray (PRINCIPLE) |
| Authorized Official Contact | 3173888131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marshall Devolopmental Therapy Services Inc 8650 Commerce Park Pl Ste A1 Indianapolis IN 46268-3174 Ph: (317) 388-8131 | Marshall Devolopmental Therapy Services Inc 308 Estes Mill Rd Walnut Grove MS 39189-5043 Ph: (317) 388-8131 |
| NPI Number | 1376188086 |
|---|---|
| Provider Enumeration Date | 11/18/2019 |
| Last Update Date | 12/09/2019 |
| Certification Date | 12/09/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376188086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |