Individual
ELISE MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
455 N LIGHT PLANT RD, AZTEC, NM 87410-1517
(505) 419-7913
Mailing address
6 ROAD 3333, AZTEC, NM 87410-9515
(505) 419-7913
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/09/2014
Last updated
10/26/2022
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