Individual
DEBRA A. MARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1007 1ST ST SW, ROANOKE, VA 24016-4401
(540) 342-2592
(540) 572-4690
Mailing address
1007 1ST ST SW, ROANOKE, VA 24016-4401
(540) 342-2592
(540) 572-4690
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002705
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001103996
—
VA
01
—
317538
ANTHEM
VA
Enumeration date
09/21/2006
Last updated
10/23/2022
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