Individual
SHANICE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1575 DELUCCHI LN, STE. #220, RENO, NV 89502-6578
(775) 825-7500
Mailing address
1575 DELUCCHI LN, STE. #220, RENO, NV 89502-6578
(775) 825-7500
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82
—
NV
Enumeration date
06/10/2015
Last updated
06/10/2015
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