Individual
EDWARD CONRADO MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
187 S CANAAN RD, CANAAN, CT 06018-2544
(877) 200-0637
(860) 945-4282
Mailing address
110 N MAIN ST, WINSTED, CT 06098-1740
(860) 201-3414
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
03-045639
CT
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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