Individual
JUDY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-08597
NM
Other
Enumeration date
11/08/2013
Last updated
12/19/2014
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