Provider Demographics
NPI:1609384536
Name:FRALEY, MARTINA EVE (BS)
Entity Type:Individual
Prefix:MS
First Name:MARTINA
Middle Name:EVE
Last Name:FRALEY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31955 STATE ROUTE 20 STE 3
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-5211
Mailing Address - Country:US
Mailing Address - Phone:800-991-6070
Mailing Address - Fax:
Practice Address - Street 1:31955 STATE ROUTE 20 STE 3
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-5211
Practice Address - Country:US
Practice Address - Phone:800-991-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician