Individual
JESUS MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
13160 COUNTY RD. 3610, ST. JAMES, MO 65559
(573) 265-3251
Mailing address
24010 ROBERTA CIR, WAYNESVILLE, MO 65583-2666
(573) 774-2424
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW002754
MO
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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