Individual
BETHANY MARCUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1403 PEMBERTON RD STE 306, RICHMOND, VA 23238-4474
(804) 741-7500
(804) 741-7900
Mailing address
1403 PEMBERTON RD STE 306, RICHMOND, VA 23238-4474
(804) 741-7500
(804) 741-7900
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810000323
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
189807
BC
VA
Enumeration date
07/08/2006
Last updated
07/09/2007
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