Healthcare Provider Details

I. General information

NPI: 1376400564
Provider Name (Legal Business Name): SANAA MARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 GARTH RD APT 204
OWINGS MILLS MD
21117-7177
US

IV. Provider business mailing address

30 W BIDDLE ST UNIT 410
BALTIMORE MD
21201-5691
US

V. Phone/Fax

Practice location:
  • Phone: 410-919-6540
  • Fax:
Mailing address:
  • Phone: 917-244-8489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number1107852
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: