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Individual

AISHA L MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4435 COBIA DR, TAMPA, FL 33617-8205
(813) 770-9983
Mailing address
4435 COBIA DR, TAMPA, FL 33617-8205
(813) 770-9983

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106S00000X
FL
Enumeration date
04/05/2019
Last updated
04/05/2019
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