Individual
MS. STACI BLAIR MARZOLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, BCBA
Contact information
Practice address
306 WESTWOOD OFFICE PARK, FREDERICKSBURG, VA 22401-5108
(856) 520-3099
Mailing address
105 BIRCH CT, LOCUST GROVE, VA 22508-5720
(856) 520-3099
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000637
VA
1041C0700X
Clinical Social Worker
0904007946
VA
Other
Enumeration date
03/28/2014
Last updated
08/05/2015
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