Individual
MRS. DALLAS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 NEWMAN ST, EAST TAWAS, MI 48730-1272
(231) 668-4909
Mailing address
1500 S DOUGLAS RD STE 230, CORAL GABLES, FL 33134-4108
(844) 854-1116
(305) 846-9711
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
MI
Other
Enumeration date
01/12/2017
Last updated
06/24/2021
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