Individual
ALISA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1113 HEREFORD RANCH RD, CHEYENNE, WY 82007-9602
(307) 760-4260
Mailing address
1113 HEREFORD RANCH RD, CHEYENNE, WY 82007-9602
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-550
WY
Other
Enumeration date
03/11/2013
Last updated
01/06/2015
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