Individual
STACY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA, COBA
Contact information
Practice address
882 EASTCHESTER DR, GAHANNA, OH 43230-5137
(919) 771-3930
Mailing address
882 EASTCHESTER DR, GAHANNA, OH 43230-5137
(919) 771-3930
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/25/2007
Last updated
07/19/2023
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