Provider Demographics
NPI:1659641215
Name:MARTENS, KATHLEEN REINDL (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:REINDL
Last Name:MARTENS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MRS
Other - First Name:KATHLEEN
Other - Middle Name:REINDL
Other - Last Name:GLUFLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:12359 SUNRISE VALLEY DR
Mailing Address - Street 2:SUITE 320
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191
Mailing Address - Country:US
Mailing Address - Phone:703-596-4796
Mailing Address - Fax:703-862-1194
Practice Address - Street 1:12359 SUNRISE VALLEY DR
Practice Address - Street 2:SUITE 320
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191
Practice Address - Country:US
Practice Address - Phone:703-596-4796
Practice Address - Fax:703-862-1194
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling