Individual
MARIE JUDITH KAZMIERCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21000 EDUCATION CT, BROADLANDS, VA 20148-5526
(571) 252-1000
Mailing address
21000 EDUCATION CT, BROADLANDS, VA 20148-5526
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005334
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202005334
COMMONWEALTH OF VIRGINIA
VA
Enumeration date
04/04/2018
Last updated
04/04/2018
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