Most Relevant Information
Provider Data
| NPI Number: | 1003676610 |
| Provider Name: | ANDREA MARTIN |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: | 002868 |
Most Important Dates
| Enumeration Date: | 03/20/2024 |
| Last Updated: | 03/20/2024 |
Provider Practice Location
54 JOANNE DR
HOLBROOK
NY
117415603
Practice Location Phone/Fax
| Phone: | 6315618309 |
| Fax: |
Provider Mailing Location
54 JOANNE DR
HOLBROOK
NY
117415603
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |