Provider Demographics
NPI:1053927152
Name:MARKS, CIERRA MONET (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:MONET
Last Name:MARKS
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 KELLY RD
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-7002
Mailing Address - Country:US
Mailing Address - Phone:917-513-0038
Mailing Address - Fax:
Practice Address - Street 1:1329 KELLY RD
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-7002
Practice Address - Country:US
Practice Address - Phone:917-513-0038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPSL001386235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist