Individual
MARY A MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,RD,LD
Contact information
Practice address
4605 CAYETANA PL NW, ALBUQUERQUE, NM 87120-4670
(505) 270-4092
Mailing address
4605 CAYETANA PL NW, ALBUQUERQUE, NM 87120-4670
(505) 270-4092
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
100
NM
Other
Enumeration date
04/15/2012
Last updated
04/15/2012
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