Individual
DEREK VINCENT MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MM, BCBA, LBS
Contact information
Practice address
999 OLD EAGLE SCHOOL RD, WAYNE, PA 19087-1707
(844) 444-7496
Mailing address
4620 N STATE ROAD 7 STE 300, LAUDERDALE LAKES, FL 33319-5867
(561) 323-6593
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH004643
PA
Other
Enumeration date
10/11/2019
Last updated
08/18/2025
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