Individual
MRS. MELANIE TANA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
720 UNIVERSITY AVE, LAS VEGAS, NM 87701-4250
(505) 454-8265
Mailing address
720 UNIVERSITY AVE, LAS VEGAS, NM 87701-4250
(505) 946-1470
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T-0125981
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78558
—
NM
Enumeration date
10/05/2010
Last updated
06/17/2011
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