Individual
PATRICIA DIANE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1970 W OLD MAGEE TRL APT 2104, TUCSON, AZ 85704-1402
(520) 721-1887
(520) 407-5398
Mailing address
PO BOX 86537, TUCSON, AZ 85754-6537
(520) 721-1887
(520) 721-0069
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
10480995
AZ
385HR2055X
Child Mental Illness Respite Care
Primary
10480995
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10480995
ADCS
AZ
Enumeration date
03/23/2022
Last updated
03/02/2026
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