Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1033783758 |
---|---|
Provider Name | Mindy Aracely Martinez |
First Address | Pasadena, CA 91106-2380 |
Second Address | Downey, CA 90242-2806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2021 |
Last Update Date | 17/05/2021 |