Individual
BETHANY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
4016 RAINTREE RD STE 200B, CHESAPEAKE, VA 23321-3757
(757) 465-3933
(757) 465-3944
Mailing address
4016 RAINTREE RD STE 200B, CHESAPEAKE, VA 23321-3757
(757) 465-3933
(757) 465-3944
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-17-26209
BABC
VA
Enumeration date
06/27/2017
Last updated
07/21/2022
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