Individual
JESSICA LYNN MALTBIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
1314 RIVERLAND RD SE, ROANOKE, VA 24014-3610
(866) 565-7222
(877) 734-1914
Mailing address
1314 RIVERLAND RD SE, ROANOKE, VA 24014-3610
(877) 565-7222
(877) 734-1914
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-23-14650
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548915507
—
VA
Enumeration date
02/18/2022
Last updated
08/18/2023
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