Provider Demographics
NPI:1053796284
Name:MARSHALL, ANNA MARIA (LMSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIA
Other - Last Name:ARCHULETA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:900 STAGECOACH RD
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124
Mailing Address - Country:US
Mailing Address - Phone:505-720-9959
Mailing Address - Fax:575-751-1371
Practice Address - Street 1:900 STAGECOACH RD
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124
Practice Address - Country:US
Practice Address - Phone:505-720-9959
Practice Address - Fax:575-751-1371
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-09787104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker