Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
N | 104100000X | Social Worker | ||
Y | 106E00000X | Assistant Behavior Analyst | FL |
NPI | 1043477151 |
---|---|
Provider Name | Georgina L. Martin |
First Address | Miami, FL 33177-6645 |
Second Address | Miami, FL 33177 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2008 |
Last Update Date | 15/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
017570000 | (05) | FL |