Individual
KOUTA MARTIN HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
1820 1ST DR, CHARLESTON, SC 29407-5756
(252) 347-7823
(888) 808-4249
Mailing address
PO BOX 80901, CHARLESTON, SC 29416-0901
(252) 347-7823
(888) 808-4249
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/14/2024
Last updated
03/14/2024
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