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Individual

MS. NELDA MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSAA

Contact information

Practice address
7 RIO SAN JOSE, LAGUNA, NM 87026
(505) 249-2444
Mailing address
7 RIO SAN JOSE, LAGUNA, NM 87026
(505) 249-2444

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0173451
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5059555901
NM DRIVERS LICENSE
NM
Enumeration date
01/09/2020
Last updated
01/09/2020
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