Individual
BRIDGET MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1911 CONTINENTAL AVE, NAPERVILLE, IL 60563-3920
(630) 518-8009
Mailing address
1911 CONTINENTAL AVE, NAPERVILLE, IL 60563-3920
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
30757
IL
101YM0800X
Mental Health Counselor
Primary
180011375
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180011375
LCPC
IL
Enumeration date
03/11/2019
Last updated
03/11/2019
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