Individual
MRS. GINA A MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8911 63RD DR, APT 124, REGO PARK, NY 11374-3852
(917) 807-8762
Mailing address
8911 63RD DR, APT 124, REGO PARK, NY 11374-3852
(917) 807-8762
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
071488-1
NY
Other
Enumeration date
06/09/2009
Last updated
06/09/2009
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