Individual
MARLA BALTAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E ROYAL LN STE 290, IRVING, TX 75039-3602
(855) 832-6727
(772) 675-9100
Mailing address
4575 SE DIXIE HWY, STUART, FL 34997-6826
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
03/01/2017
Last updated
03/01/2017
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