Organization
ANIMA MUNDI PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHLEE MARIE MARTINEZ PSYD (OWNER/PSYCHOLOGIST)
(210) 593-8729
Entity
Organization
Contact information
Practice address
27698 KORNEGAY RD, SAN BENITO, TX 78586-7585
(210) 593-8729
Mailing address
27698 KORNEGAY RD, SAN BENITO, TX 78586-7585
(210) 593-8729
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
Primary
—
—
103TF0000X
Family Psychologist
—
—
103TH0004X
Health Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619459930
REGINA MASON-VANBURG
TX
Enumeration date
09/20/2023
Last updated
10/08/2023
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