Individual
SHAYLEE MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4001 OFFICE COURT DR STE 102, SANTA FE, NM 87507-4903
(505) 983-8225
(505) 930-5427
Mailing address
PO BOX 807, CHIMAYO, NM 87522-0807
(505) 484-0973
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
X12209
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15510755
CAQH
NM
Enumeration date
02/10/2022
Last updated
02/10/2022
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