1548572712 NPI number — MRS. KATHRYN WENDLER MARKS M.S. CCC SLP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548572712 NPI number — MRS. KATHRYN WENDLER MARKS M.S. CCC SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARKS
Provider First Name:
KATHRYN
Provider Middle Name:
WENDLER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S. CCC SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WENDLER
Provider Other First Name:
KATHRYN
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S. CCC SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1548572712
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2307 JEFFERSON DAVIS HIGHWAY
Provider Second Line Business Mailing Address:
UNIT 101
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-417-0447
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6506 LOISDALE RD
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22150-1824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-924-4100
Provider Business Practice Location Address Fax Number:
703-924-0126
Provider Enumeration Date:
07/05/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  235Z00000X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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