Individual
NIKOLAUS OWEN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, BCBA, LBA
Contact information
Practice address
3602 E GREENWAY RD STE 102, PHOENIX, AZ 85032-4648
(602) 560-2832
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-22-62161
IN
103K00000X
Behavior Analyst
Primary
BEH-001071
AZ
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-22-62161
BCBA CERTIFICATE
—
Enumeration date
02/23/2019
Last updated
07/17/2025
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