Individual
LANITA ANN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
669 AZALEA RD, MOBILE, AL 36609-1515
(251) 422-1827
Mailing address
669 AZALEA RD, MOBILE, AL 36609-1515
(251) 340-2067
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-304818
AL
Other
Enumeration date
02/12/2024
Last updated
10/10/2024
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