Doctor Name: | MARTIN D TEJADA |
NPI Number: | 1033201934 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 7822 |
Business Practice Address: | 5250 Nw Mayfield Ln Port St Lucie, FL - 349835351 |
Business Phone Number: | 7723430284 |
Business Fax Number: | |
Mailing Address: | 5250 Nw Mayfield Ln, PORT ST LUCIE |
State: | FL |
Postal Code: | 349835351 |
Phone Number: | 7723430284 |
Fax Number: | |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 7822 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |