Individual
AMANDA A MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6123 GREEN BAY RD STE 140, KENOSHA, WI 53142-2927
(262) 358-4459
Mailing address
8420 204TH CIR, BRISTOL, WI 53104-9144
(414) 254-8084
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7758-226
WI
Other
Enumeration date
04/22/2025
Last updated
04/22/2025
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