Individual
MARTINESE GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 725-1706
(734) 326-7472
Mailing address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 725-1706
(734) 326-7472
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/04/2021
Last updated
10/14/2024
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