Individual
JOHANNA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8221 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4512
(703) 559-3126
Mailing address
8221 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4512
(703) 559-3126
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904008210
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154356244
—
VA
Enumeration date
04/24/2019
Last updated
04/24/2019
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