Individual
ILEANA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
200 MAIN ST, PAWTUCKET, RI 02860-4131
(401) 728-1800
Mailing address
28 CLARK MILL ST, COVENTRY, RI 02816-6339
(774) 331-1500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW02037
RI
Other
Enumeration date
09/01/2017
Last updated
04/15/2020
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