Individual
MISS FABIOLA NAHIR MARTINEZ-PESANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3046 W ARMITAGE AVE, CHICAGO, IL 60647-5935
(872) 588-6011
Mailing address
1950 N CAMPBELL AVE UNIT 203N, CHICAGO, IL 60647-0014
(787) 975-3235
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073183554
N/A
—
Enumeration date
09/08/2022
Last updated
09/08/2022
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