Individual
ANDREW MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
8620 W EMERALD ST STE 150, BOISE, ID 83704-4839
(208) 617-3265
Mailing address
411 19TH AVE N, NAMPA, ID 83687-4442
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
ID
Other
Enumeration date
11/07/2025
Last updated
11/07/2025
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