Individual
HILDA ALTAGRACIA MARTINEZ-GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2415 MEYER AVENUE SOUTHWEST, WYOMING, MI 49519
(616) 805-9201
Mailing address
2415 MEYER AVENUE SOUTHWEST, WYOMING, MI 49519
(616) 805-9201
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401223922
MI
101YM0800X
Mental Health Counselor
6401223922
MI
101YP2500X
Professional Counselor
Primary
6401223922
MI
Other
Enumeration date
08/26/2024
Last updated
08/26/2024
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