Individual
BLAKE MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
1148 4TH ST, MUSKEGON, MI 49441-1907
(231) 726-2299
Mailing address
1148 4TH ST, MUSKEGON, MI 49441-1907
(231) 726-2299
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301016267
MI
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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