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Individual
MR. ROLANDO THOMAS MARTINEZ
Active
Individual
MR. ROLANDO THOMAS MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW, LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000839
CT
1041C0700X
Clinical Social Worker
Primary
001095
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649288390
—
CT
01
—
D400060106
MEDICARE
CT
Enumeration date
08/04/2006
Last updated
01/03/2012
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