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Individual

GERRY A MARTINEZ

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MFT

Contact information

Practice address
1400 BELLINGER ST, EAU CLAIRE, WI 54703-5222
(715) 838-3806
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
613
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43587200
WI
Enumeration date
05/11/2006
Last updated
07/08/2007
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