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General NPI Number Information
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NPI Number | 1386185387
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Entity Type | Organization
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Legal Business Name | STEPHANIE CRUZ MARTINEZ
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Dates
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Enumeration Date | 03/10/2017
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Last Update Date | 03/10/2017
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Provider Practice Location Address
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Address Line | 737 SW 109TH AVE APT. 1201A
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City | MIAMI
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State | FL
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Zip | 33174-1339
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Country | US
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Telephone | 787-677-1837
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Fax |
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Provider Business Mailing Address
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Address Line | 737 SW 109TH AVE APT. 1201A
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City | MIAMI
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State | FL
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Zip | 33174-1339
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BEHAVIOR TECHNICIAN
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Name | STEPHANIE CRUZ MARTINEZ
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Credential |
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Telephone | 787-677-1837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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