Individual
PATRICIA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2225 BEMISS RD STE D, VALDOSTA, GA 31602-4819
(800) 832-9419
(855) 859-1671
Mailing address
2225 BEMISS RD STE D, VALDOSTA, GA 31602-4819
(800) 832-9419
(855) 859-1671
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-17-45482
GA
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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