Individual
MS. MARJORIE JANE THEOBALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA/LABA
Contact information
Practice address
9 PINNACLE DR, FISHERSVILLE, VA 22939-2366
(804) 915-6400
Mailing address
11 TANGLEWOOD RD, PALMYRA, VA 22963-3314
(434) 282-4831
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0134000371
VA
Other
Enumeration date
02/08/2022
Last updated
02/08/2022
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