Individual
MS. MARTHA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4604 SNAPDRAGON RD NW, ALBUQUERQUE, NM 87120-2752
(505) 944-6991
Mailing address
4604 SNAPDRAGON RD NW, ALBUQUERQUE, NM 87120-2752
(505) 944-6991
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
104731
TX
1041C0700X
Clinical Social Worker
Primary
C-11537
NM
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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