Individual
EBONY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
614 N 6TH ST STE B, SPRINGFIELD, IL 62702-5314
(217) 960-0530
Mailing address
614 N 6TH ST STE B, SPRINGFIELD, IL 62702-5314
(217) 960-0530
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-436032
IL
106S00000X
Behavior Technician
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—
Other
Enumeration date
04/18/2023
Last updated
08/15/2025
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