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General NPI Number Information
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NPI Number | 1649146796
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Entity Type | Individual
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Provider Name | GENESIS BRISELDA ORELLANA MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 13913 S WESTERN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73170-7011
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Country | US
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Telephone | 405-445-5567
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Fax |
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Provider Business Mailing Address
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Address Line | 101 NE 53RD ST APT 3101
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City | OKLAHOMA CITY
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State | OK
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Zip | 73105-1886
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Country | US
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Telephone | 405-532-6275
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | RBT-25-480734
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License Number State | OK
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