Individual
MR. CHARLES BRENT MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., BCBA
Contact information
Practice address
1120 JENKS AVE, PANAMA CITY, FL 32401-2439
(850) 215-6770
(850) 665-0123
Mailing address
1120 JENKS AVE, PANAMA CITY, FL 32401-2439
(850) 215-6770
(850) 665-0123
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-6993
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017665000
—
FL
Enumeration date
09/28/2015
Last updated
04/15/2025
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