Individual
RENELLE DENEEN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
538 BROADHOLLOW RD, MELVILLE, NY 11747-3676
(631) 385-7780
Mailing address
21946 93RD AVE APT 4D, QUEENS VILLAGE, NY 11428-1818
(917) 679-5103
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/14/2017
Last updated
03/25/2026
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