Doctor Name: | LUCERO MARTINEZ |
NPI Number: | 1053705723 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 5710 |
Business Practice Address: | 1301 Washington St Anthony, NM - 880218846 |
Business Phone Number: | 5758826101 |
Business Fax Number: | 5758826926 |
Mailing Address: | Po Box 70, ANTHONY |
State: | NM |
Postal Code: | 880210070 |
Phone Number: | 5758826101 |
Fax Number: | 5758826926 |
NPI Enumeration Date: | 03/20/2015 |
NPI Last Update Date: | 03/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | 5710 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |