Provider Demographics
NPI:1235530429
Name:VON KOLNITZ, MARION
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:VON KOLNITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7200
Mailing Address - Country:US
Mailing Address - Phone:843-849-2841
Mailing Address - Fax:
Practice Address - Street 1:385 EGYPT RD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7200
Practice Address - Country:US
Practice Address - Phone:843-849-2841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist