Individual
CASSANDRA L MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 TIDEWATER AVE, MASSAPEQUA, NY 11758-8423
(516) 852-0688
Mailing address
12 TIDEWATER AVE, MASSAPEQUA, NY 11758-8423
(516) 852-0688
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000036
NY
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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