Provider Demographics
NPI:1467180232
Name:MARTINEZ, JUSTIN (RBT)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 SOCIALVILLE FOSTER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-7353
Mailing Address - Country:US
Mailing Address - Phone:513-322-5779
Mailing Address - Fax:
Practice Address - Street 1:3611 SOCIALVILLE FOSTER RD STE 101
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-7353
Practice Address - Country:US
Practice Address - Phone:513-322-5779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLRBT-22-228089106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician