Individual
MICHELLE MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2858 W DIVERSEY AVE, CHICAGO, IL 60647-1871
(312) 945-0354
Mailing address
3910 N NEWLAND AVE, CHICAGO, IL 60634-2315
(312) 478-9683
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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