Provider Information for 1124267711
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NIA L MARTINEZ LISW
Sex: Female
NPI: 1124267711
Last Updated: 2014-09-10
Certification Date:
Certification Date:
Details
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NPI | 1124267711 | ||||||||
Enumeration Date | 2009-02-05 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 2218 W. GRAND AVE ARTESIA, NM 88211-0155 United States Phone: 575-317-2109 | Fax:575-748-6160 | ||||||||
Primary Practice Address | 2218 W. GRAND AVE ARTESIA, NM 88211-0155 United States Phone: 575-317-2109 | Fax:575-748-6160 | ||||||||
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