Individual
BENITA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
S 312 JAGUAR DRIVE, SANTA FE, NM 87507
(505) 310-4746
Mailing address
S 312 JAGUAR DRIVE, SANTA FE, NM 87507
(505) 310-4746
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
CSA0203021
NM
Other
Enumeration date
02/24/2014
Last updated
04/30/2019
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