Provider Demographics
NPI:1275654899
Name:KUNZ, MARIAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:
Last Name:KUNZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 RILEYS WAY
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23664-1964
Mailing Address - Country:US
Mailing Address - Phone:757-224-4443
Mailing Address - Fax:
Practice Address - Street 1:305 MARCELLA RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2433
Practice Address - Country:US
Practice Address - Phone:757-827-8953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002480235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist