Mariah Laryssa Martinez
Behavior Technician in Las Vegas, NV. Individual provider (NPI-1).
NPI number1124757992
StatusActive
Last updated in NPPESJun 8, 2022
Details
- NPI
- 1124757992
- Entity type
- Individual (NPI-1)
- Name
- Mariah Laryssa Martinez
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 7, 2022
- Certification date
- Jun 8, 2022
- Last updated
- Jun 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
9713 Windom Point AveLas Vegas, NV 89129-7921
Phone 669-350-8713
Mailing address
9713 Windom Point AveLas Vegas, NV 89129-7921
Phone 669-350-8713
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