Provider Demographics
NPI:1255487047
Name:DUBROW-MARSHALL, LINDA (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:DUBROW-MARSHALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MERTHYR ROAD
Mailing Address - Street 2:
Mailing Address - City:PONTYPRIDD
Mailing Address - State:GB
Mailing Address - Zip Code:CF37 4DD
Mailing Address - Country:GB
Mailing Address - Phone:01144144-340-0456
Mailing Address - Fax:
Practice Address - Street 1:9877 VERREE RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-1927
Practice Address - Country:US
Practice Address - Phone:215-698-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003091-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA199756Medicare ID - Type Unspecified
PAR06623Medicare UPIN