Provider Demographics
NPI:1790560076
Name:MARSHALL-ROBERTS, JANICE A (BCBA)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:A
Last Name:MARSHALL-ROBERTS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 CINDY LN NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-1227
Mailing Address - Country:US
Mailing Address - Phone:678-849-9571
Mailing Address - Fax:
Practice Address - Street 1:4510 CINDY LN NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-1227
Practice Address - Country:US
Practice Address - Phone:678-849-9571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst