Provider Demographics
NPI:1962079780
Name:MARVEL, KARSON NICOLE (AUD)
Entity type:Individual
Prefix:DR
First Name:KARSON
Middle Name:NICOLE
Last Name:MARVEL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 BRANDY SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:PARKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21120-9748
Mailing Address - Country:US
Mailing Address - Phone:443-695-2397
Mailing Address - Fax:
Practice Address - Street 1:1447 YORK RD STE 312
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-6052
Practice Address - Country:US
Practice Address - Phone:410-583-7021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01555231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist