Provider Demographics
NPI:1548572712
Name:MARKS, KATHRYN WENDLER (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:WENDLER
Last Name:MARKS
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:ANN
Other - Last Name:WENDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:2307 JEFFERSON DAVIS HIGHWAY
Mailing Address - Street 2:UNIT 101
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22301
Mailing Address - Country:US
Mailing Address - Phone:502-417-0447
Mailing Address - Fax:
Practice Address - Street 1:6506 LOISDALE RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1824
Practice Address - Country:US
Practice Address - Phone:703-924-4100
Practice Address - Fax:703-924-0126
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-05
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA235Z00000X235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist