Individual
ALYSSA MARTENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4997 ROYAL GULF CIR, FORT MYERS, FL 33966-7006
(239) 313-5049
(239) 313-5712
Mailing address
4997 ROYAL GULF CIR, FORT MYERS, FL 33966-7006
(239) 313-5049
(239) 313-5712
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-21-173176
RBT LICENSE
—
Enumeration date
06/29/2021
Last updated
06/29/2021
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