MEDICARE: MARTHA ANN STOKES PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	14854	TX

General Provider Information

NPI Number	:	1679676977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA ANN STOKES PHD

Provider Business Mailing Address
First Line	:	110 LUKE AVE.
Second Line	:	SUITE 400
City	:	BOLLING AFB
State	:	DC
Zip	:	20032-7050
Country	:	US
Telephone Number	:	202-404-6545
Fax Number	:	202-404-7366

Provider Business Practice Location Address
First Line	:	110 LUKE AVE.
Second Line	:	SUITE 400
City	:	BOLLING AFB
State	:	DC
Zip	:	20032-7050
Country	:	US
Telephone Number	:	202-404-6545
Fax Number	:	202-404-7366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	07/08/2007

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Directions to “ MARTHA ANN STOKES PHD” Practice Location

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