Individual
MS. TRACY ILENE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
214 FERREL ST, PLATTE CITY, MO 64079-9511
(816) 469-5162
Mailing address
47 N 77TH ST, KANSAS CITY, KS 66111-2903
(913) 212-8418
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/16/2024
Last updated
01/16/2024
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