Provider Demographics
NPI:1194406298
Name:MARTINEZ, MICHELE MARIE (RBT)
Entity type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:MARIE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:MARIE
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1690 BELTLINE RD SW STE B
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-5505
Mailing Address - Country:US
Mailing Address - Phone:256-686-3169
Mailing Address - Fax:
Practice Address - Street 1:1690 BELTLINE RD SW STE B
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-5505
Practice Address - Country:US
Practice Address - Phone:256-686-3169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician