MEDICARE: EMILIE JANE MARTIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-25-493185	CO

General Provider Information

NPI Number	:	1265393110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILIE JANE MARTIN

Provider Business Mailing Address
First Line	:	1480 E CALVADA BLVD STE 700
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89048-3963
Country	:	US
Telephone Number	:	775-419-7595
Fax Number	:	833-939-0185

Provider Business Practice Location Address
First Line	:	1480 E CALVADA BLVD STE 700
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89048-3963
Country	:	US
Telephone Number	:	775-419-7595
Fax Number	:	833-939-0185

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2025
Last Update Date	:	04/06/2026

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Directions to “ EMILIE JANE MARTIN ” Practice Location

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