Individual
MISS MADELYNE MILDRED MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2632 E THOMAS RD STE 101, PHOENIX, AZ 85016-8220
(602) 957-2507
(602) 957-2510
Mailing address
3200 MOTOR AVENUE, LOS ANGELES, CA 90034
(310) 836-1223
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW17998
AZ
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
09/14/2012
Last updated
12/30/2022
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