Individual
MRS. KELLY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
68 WOODRIDGE RD, EAST HAMPSTEAD, NH 03826-2405
(978) 479-5090
Mailing address
68 WOODRIDGE RD, EAST HAMPSTEAD, NH 03826-2405
(978) 479-5090
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BACB559898
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109970
STATE OF NH BOARD OF EDUCATION
NH
01
—
BACB559898
BACB
NH
Enumeration date
05/24/2022
Last updated
05/24/2022
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