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Individual

KEVIN ALAN MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LISW

Contact information

Practice address
546 N 10TH STREET, FORT SUMNER, NM 88119-0349
(575) 355-2420
(575) 355-7894
Mailing address
PO BOX 349, 546 NORTH 10TH ST, FORT SUMNER, NM 88119-0349
(575) 355-2420
(575) 355-7894

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-08098
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
74705075
NM
Enumeration date
01/24/2007
Last updated
11/25/2015
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