Individual
LORIE MARTINEZ CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2002 GREGORY DR, TAMPA, FL 33613-2541
(786) 468-9975
Mailing address
2002 GREGORY DR, TAMPA, FL 33613-2541
(786) 468-9975
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-26-16964
FL
106S00000X
Behavior Technician
RBT-19-108014
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105709500
—
FL
Enumeration date
02/29/2020
Last updated
03/06/2026
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