Individual
STEPHANIE MARIE MARTINEZ-MORALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
206 PARK PLACE BLVD, KISSIMMEE, FL 34741-2344
(407) 846-0023
Mailing address
1848 SE 1ST AVE, FORT LAUDERDALE, FL 33316-2875
(954) 885-9500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
PY11188
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/27/2012
Last updated
08/24/2021
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