Individual
JULISSA MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1506 HAVEN CREST DR, POWDER SPRINGS, GA 30127-4960
(787) 368-7614
Mailing address
1506 HAVEN CREST DR, POWDER SPRINGS, GA 30127-4960
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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