Provider Demographics
NPI:1699151753
Name:MARKS, KATHY LASHUNDA
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:LASHUNDA
Last Name:MARKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 W 2ND ST N
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AR
Mailing Address - Zip Code:71857-3654
Mailing Address - Country:US
Mailing Address - Phone:870-540-6519
Mailing Address - Fax:
Practice Address - Street 1:2410 PINE ST
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-4335
Practice Address - Country:US
Practice Address - Phone:870-245-2210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor