Individual
DANA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16414 LAKE CHURCH DR, ODESSA, FL 33556-2637
(813) 926-5454
Mailing address
59 MANOR RD, OAKDALE, CT 06370-1215
(860) 917-7467
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29396
CT
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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