Individual
MARTINE HENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4922 LASALLE RD, HYATTSVILLE, MD 20782-3302
(301) 864-2333
Mailing address
4922 LASALLE RD, HYATTSVILLE, MD 20782-3302
(301) 864-2333
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
06568
MD
Other
Enumeration date
01/03/2007
Last updated
06/09/2015
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