Individual
SUSAN E MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHP4280 MSW(1662) L
Contact information
Practice address
2626 BROADWAY, SCOTTSBLUFF, NE 69341
(308) 633-3726
(308) 633-2847
Mailing address
2626 BROADWAY, SCOTTSBLUFF, NE 69361
(308) 633-3726
(308) 633-2847
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8745
NE
101YM0800X
Mental Health Counselor
Primary
LCSW4820
NE
Other
Enumeration date
11/13/2013
Last updated
11/04/2016
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