Individual
CIDERRA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3600 W SHAKESPEARE AVE, CHICAGO, IL 60647-6211
(214) 304-9924
Mailing address
3600 W SHAKESPEARE AVE, CHICAGO, IL 60647-6211
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-418560
TX
Other
Enumeration date
01/16/2026
Last updated
01/16/2026
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