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Individual
ODELAYSI VIRGEN SELLES MARTINEZ X
Active
Individual
ODELAYSI VIRGEN SELLES MARTINEZ X
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BACB670274
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
21-169241
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21-169245
RBT
FL
Enumeration date
03/11/2022
Last updated
04/02/2022
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