Individual
MARISSA EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
10715 SPOTSYLVANIA AVE, FREDERICKSBURG, VA 22408-2674
(540) 339-3640
(540) 898-1040
Mailing address
10715 SPOTSYLVANIA AVE, FREDERICKSBURG, VA 22408-2674
(540) 339-3640
(540) 898-1040
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-23729
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-16-23729
BACB
VA
Enumeration date
05/15/2017
Last updated
04/04/2023
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