Provider Demographics
NPI:1053716761
Name:MARSLAND, JENNIFER YVONNE (LMT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:YVONNE
Last Name:MARSLAND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 NANDINA DR
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-7365
Mailing Address - Country:US
Mailing Address - Phone:360-774-6435
Mailing Address - Fax:
Practice Address - Street 1:516 NANDINA DR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-7365
Practice Address - Country:US
Practice Address - Phone:843-329-9989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8887225700000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374J00000XNursing Service Related ProvidersDoula