Individual
MARIE RATLIFF-BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9351 W BROAD ST, HENRICO, VA 23294-5437
(804) 596-3275
Mailing address
9351 W BROAD ST, HENRICO, VA 23294-5437
(804) 596-3275
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133002020
VA
106S00000X
Behavior Technician
RBT-15-08130
VA
Other
Enumeration date
06/17/2019
Last updated
06/09/2021
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