Individual
MR. ISAIAS MAFFETT MARTINEZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2546 WOOD BEND LN, 30296, GA 30134
(678) 340-1371
Mailing address
252 BRIDGE PL, DOUGLASVILLE, GA 30134-5158
(404) 667-8984
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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