Individual
MS. COLLEEN DALY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, RPT-S
Contact information
Practice address
11 S FULLERTON AVE, MONTCLAIR, NJ 07042-6304
(973) 744-8400
Mailing address
32 SAINT LUKES PL APT 2, MONTCLAIR, NJ 07042-2139
(973) 233-1304
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC04534000
NJ
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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