Provider Demographics
NPI:1376968651
Name:MARKS, MARIA CLAUDIA
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CLAUDIA
Last Name:MARKS
Suffix:
Gender:F
Credentials:
Other - Prefix:MR
Other - First Name:JERRY
Other - Middle Name:
Other - Last Name:MARKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:0019011992
Mailing Address - Street 1:9310 FLANAGAN CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-8902
Mailing Address - Country:US
Mailing Address - Phone:703-309-3908
Mailing Address - Fax:703-361-9718
Practice Address - Street 1:13601 OFFICE PL
Practice Address - Street 2:SUITE 104
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4213
Practice Address - Country:US
Practice Address - Phone:703-309-3908
Practice Address - Fax:703-361-9718
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019011992225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist