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Individual

STEPHANIE MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSCSW

Contact information

Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 928-1430
Mailing address
1343 N WOODLAWN BLVD, DERBY, KS 67037-2920
(316) 655-5641

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
9241
KS
1041C0700X
Clinical Social Worker
Primary
5250
KS

Other

Enumeration date
06/18/2014
Last updated
08/18/2020
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