Individual
DYLAN R MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
105 PASEO DEL CANON W STE A, TAOS, NM 87571-6943
(575) 737-5533
Mailing address
105 PASEO DEL CANON W STE A, TAOS, NM 87571-6943
(575) 737-5533
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
08/07/2025
Last updated
12/18/2025
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