| Provider / Organization | NPI | Date Certified |
|---|---|---|
| DOMINIQUE NICIA MARTINEZ | 1205407418 | 2021-07-12 |
Dominique Nicia Martinez is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1205407418. Registration indicates Dominique Nicia Martinez is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
| Entity Type | Individual |
| Provider Name | Dominique Nicia Martinez |
| Practice Office Address | 1811 GRAND CANAL BLVD STE 2 STOCKTON, CA US |
| Practice Office Telephone | 2097828445 |
| Mailing Address | 500 FAIRWAY DR STE 102 DEERFIELD BEACH, FL 334411817 US |
| Business Telephone | 8774182978 |
| Business Fax | 8665002186 |
| Code | Practice | License No State |
|---|---|---|
| 106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician |
CA |