Individual
TERESA MIA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1800 OLD PECOS TRL STE G, SANTA FE, NM 87505-4759
(505) 954-9940
Mailing address
5714 QUAY DR NE, RIO RANCHO, NM 87144-5157
(505) 681-9942
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4023
NM
Other
Enumeration date
11/10/2006
Last updated
07/08/2007
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