Most Relevant Information
Provider Data
| NPI Number: | 1003414475 |
| Provider Name: | MARLEN ISABEL MARTIN MENENDEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | 20123525 |
Most Important Dates
| Enumeration Date: | 10/16/2020 |
| Last Updated: | 10/16/2020 |
Provider Practice Location
9375 SW 173RD TER
PALMETTO BAY
FL
331575703
Practice Location Phone/Fax
| Phone: | 7867314828 |
| Fax: |
Provider Mailing Location
9375 SW 173RD TER
PALMETTO BAY
FL
331575703
Provider Mailing Phone/Fax
| Phone: | 7867314828 |
| Fax: |