Individual
DONICIA G MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3971 S 4000 W, WEST HAVEN, UT 84401-9675
(801) 814-7378
Mailing address
3971 S 4000 W, WEST HAVEN, UT 84401-9675
(801) 814-7378
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/21/2010
Last updated
09/21/2010
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