Tia Tajuana Martin

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

CNA197753 Issued in FL

Practice address

1723 Illinois Ave
Lynn Haven, FL 32444-4374

Phone

(850) 532-4749

NPI assigned

Apr 28, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524873600000",
    "number": "1760970321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 ILLINOIS AVE",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324444374",
            "telephone_number": "850-532-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 ILLINOIS AVE",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324444374",
            "telephone_number": "850-532-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TIA",
        "middle_name": "TAJUANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-28",
        "last_updated": "2018-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "CNA197753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl E Mantecon Sr., RPH
• Marcia Pell Cde RDN LDN LLC
• Maria U Tedtaotao MD PA
• Mark M. Williams, M.D., P.a.
• Jeannie Guerelle Marquis, LMT
• Irina Mayberry, APRN
• MDL Health, PLLC
• Medstop PL LLC
• Daniel G Melzer, DMD
• Marcia B Melzer, M.,ED.,CCC/SLP

• Behavior Analyst in Lynn Haven, FL
• Providers in Lynn Haven, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.