Provider Demographics
NPI:1932659471
Name:FERRANCE, THERESA (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:FERRANCE
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 CONNECTICUT AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-2303
Mailing Address - Country:US
Mailing Address - Phone:804-357-8143
Mailing Address - Fax:
Practice Address - Street 1:11311 BUSINESS CENTER DR STE C
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3199
Practice Address - Country:US
Practice Address - Phone:804-378-6141
Practice Address - Fax:804-378-6183
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1033000806103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst