Provider Demographics
NPI:1518319730
Name:SAVANNAH MARTINEZ
Entity Type:Organization
Organization Name:SAVANNAH MARTINEZ
Other - Org Name:ABA THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ABA THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAVANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RBT
Authorized Official - Phone:210-763-6259
Mailing Address - Street 1:2977 FIREWHEEL DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-7321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2977 FIREWHEEL DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-7321
Practice Address - Country:US
Practice Address - Phone:210-763-6259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-14-00326251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health