Individual
MELISSA JEAN MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
200 CENTER STREET, MORIARTY, NM 87035
(505) 832-5957
Mailing address
PO BOX 2000, MORIARTY, NM 87035-2000
(505) 832-5957
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
349678
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349678
—
NM
Enumeration date
04/13/2012
Last updated
04/13/2012
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