Tailor Martelli
Behavior Technician in Modesto, CA. Individual provider (NPI-1).
NPI number1982242533
StatusActive
Last updated in NPPESDec 13, 2019
Details
- NPI
- 1982242533
- Entity type
- Individual (NPI-1)
- Name
- Tailor Martelli
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 13, 2019
- Certification date
- Dec 13, 2019
- Last updated
- Dec 13, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Other names
- Tailor Smith (Former Name)
Practice location
3425 Coffee Rd Ste C2Modesto, CA 95355-1582
Phone 360-846-0636
Mailing address
3425 Coffee Rd Ste C2Modesto, CA 95355-1582
Other practice locations
1203 Cowlitz Way Apt 5
Kelso, WA 98626-4701
Kelso, WA 98626-4701
Phone 360-846-0636
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