Individual
JUAN LUIS MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSAA
Contact information
Practice address
4001 OFFICE COURT DR STE 701, SANTA FE, NM 87507-4905
(505) 207-8929
Mailing address
4001 OFFICE COURT DR STE 701, SANTA FE, NM 87507-4905
(505) 207-8929
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0200581
NM
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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