| Provider / Organization | NPI | Date Certified |
|---|---|---|
| TRACEE DIANE MARTIN | 1518546944 | 2021-04-04 |
Tracee Diane Martin is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1518546944. Registration indicates Tracee Diane Martin 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 | Tracee Diane Martin |
| Practice Office Address | 202 HOWARD ST STE 3 AUBURNDALE, FL US |
| Practice Office Telephone | 8635513300 |
| Mailing Address | PO BOX 1057 LAKE ALFRED, FL 338501057 US |
| Code | Practice | License No State |
|---|---|---|
| 106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician | RBT-21-161728
FL |