Individual
ELIZABETH MARTINEZ MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
2426 W BROADWAY AVE, MINNEAPOLIS, MN 55411-1735
(612) 302-8200
Mailing address
2426 W BROADWAY AVE, MINNEAPOLIS, MN 55411-1735
(126) 302-8200
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP6636
MN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/03/2019
Last updated
06/30/2023
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