MEDICARE: MS. MARLENE RAE TRAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-25-85591	VA

General Provider Information

NPI Number	:	1770271546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARLENE RAE TRAN

Provider Business Mailing Address
First Line	:	801 HIGH POINT AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-4707
Country	:	US
Telephone Number	:	757-392-5537
Fax Number	:	757-797-0207

Provider Business Practice Location Address
First Line	:	801 HIGH POINT AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-4707
Country	:	US
Telephone Number	:	757-392-5537
Fax Number	:	757-797-0207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2023
Last Update Date	:	12/30/2025

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