Individual
ALYSSA DESARAE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3190 NORTHEAST EXPY NE, ATLANTA, GA 30341-5304
(404) 487-6005
Mailing address
1316 LAWRENCE ST, ROSENBERG, TX 77471-3830
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-370820
TX
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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