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Individual

DESIRAE MARTINEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PLPC

Contact information

Practice address
11166 TESSON FERRY RD STE 300, SAINT LOUIS, MO 63123-6966
(314) 898-0102
(314) 842-2552
Mailing address
2650 OLIVE ST, SAINT LOUIS, MO 63103-1489
(314) 533-8200
(314) 842-2552

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2024007349
MO

Other

Enumeration date
03/19/2024
Last updated
03/19/2024
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