Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-20-42592 | FL |
N | 106E00000X | Assistant Behavior Analyst | FL | |
N | 106S00000X | Behavior Technician | RBT-18-53333 | FL |
NPI | 1033606843 |
---|---|
Provider Name | Marta Helena Domech Martin |
First Address | Hialeah, FL 33015-2251 |
Second Address | Hialeah, FL 33015-2251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2018 |
Last Update Date | 19/09/2021 |