Individual
GEORGINA L. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
17421 SW 144TH CT, MIAMI, FL 33177
(786) 556-8983
Mailing address
17421 SW 144TH CT, MIAMI, FL 33177-6645
(786) 556-8983
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
—
—
106E00000X
Assistant Behavior Analyst
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017570000
—
FL
Enumeration date
05/19/2008
Last updated
06/15/2018
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