Individual
MRS. ROSELLA G. MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SAA
Contact information
Practice address
413 SIPAPU ST, BOX 6952, TAOS, NM 87571-6489
(575) 758-5758
(575) 758-2832
Mailing address
GALLINA CANYON ROAD, HOUSE #12, VALDEZ, NM 87580
(575) 776-8009
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0111351
NM
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/22/2009
Last updated
09/22/2009
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