Individual
MR. MARCUS THEA BLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED,RBT
Contact information
Practice address
2820 WATERFORD LAKE DR, MIDLOTHIAN, VA 23112-3994
(804) 658-4509
Mailing address
17610 FOX BRANCH RD, CARSON, VA 23830-2307
(804) 490-8760
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-18-52170
VA
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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