Provider Demographics
NPI:1801017215
Name:MARINO, EUGENIA
Entity Type:Individual
Prefix:MISS
First Name:EUGENIA
Middle Name:
Last Name:MARINO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:GENA
Other - Middle Name:
Other - Last Name:SMOLITSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8120 GATEHOUSE RD
Mailing Address - Street 2:#1
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1204
Mailing Address - Country:US
Mailing Address - Phone:703-534-4344
Mailing Address - Fax:703-204-0144
Practice Address - Street 1:8120 GATEHOUSE RD
Practice Address - Street 2:#1
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1204
Practice Address - Country:US
Practice Address - Phone:703-534-4344
Practice Address - Fax:703-204-0144
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001221231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist