Individual
VANYSSA MARBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
115 W IDAHO ST, WEISER, ID 83672-1945
(208) 549-0330
Mailing address
115 W IDAHO ST, WEISER, ID 83672-1945
(208) 549-0330
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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