Individual
ELIZABETH MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1490 GREGORY LN, JACKSON, WY 83001-9021
(307) 734-6040
Mailing address
PO BOX 8324, JACKSON, WY 83002-8324
(307) 699-3314
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1400
WY
1041C0700X
Clinical Social Worker
LCSW-41631
ID
Other
Enumeration date
06/13/2019
Last updated
08/04/2022
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