Individual
DR. ALFONSO MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
6000 SHAKERAG HL, SUITE 216, PEACHTREE CITY, GA 30269-6523
(770) 632-1088
(770) 632-2088
Mailing address
406 MOUNT VERNON TRCE, PEACHTREE CITY, GA 30269-2641
(770) 629-4575
(770) 629-4575
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY3117
GA
103T00000X
Psychologist
PY5814
FL
Other
Enumeration date
11/29/2005
Last updated
11/28/2007
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