Individual
NICHOLAS MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
9100 MISSION RD, PRAIRIE VILLAGE, KS 66206-1714
(913) 735-3393
Mailing address
3965 W 83RD ST # 157, PRAIRIE VILLAGE, KS 66208-5308
(913) 735-3393
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-160408
KS
Other
Enumeration date
03/18/2021
Last updated
03/18/2021
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