Individual
AMANDA RENEE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
4001 11TH ST, RIVERSIDE, CA 92501-3501
(951) 346-4860
Mailing address
1166 W EVANS ST, SAN BERNARDINO, CA 92411-1817
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
11727180
CA
Other
Enumeration date
09/27/2017
Last updated
09/27/2017
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