Provider Demographics
NPI:1730448515
Name:LOVE, MARSHAY (MS)
Entity type:Individual
Prefix:
First Name:MARSHAY
Middle Name:
Last Name:LOVE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 PRESTON RD
Mailing Address - Street 2:218
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7440
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4225 OFFICE PKWY
Practice Address - Street 2:A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-3628
Practice Address - Country:US
Practice Address - Phone:214-821-6505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080579802Medicaid