Individual
DAFNE MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3228 S PULASKI RD, CHICAGO, IL 60623-4919
(773) 827-6109
Mailing address
2433 N WESTERN AVE, CHICAGO, IL 60647-2028
(773) 827-6109
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
11697733
NM
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
394957856
—
IL
Enumeration date
10/06/2022
Last updated
01/12/2024
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