| NPI | 1477106243 |
|---|---|
| Former Name | ELLIE S MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NE 12766) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NE 19-95895) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2024-04-05 |