| Doctor Name: | MR. JACOB ALBERT MARTINEZ |
| NPI Number: | 1366742074 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA, CCC-SLP |
| License Number: | 4714 |
| Business Practice Address: | 4441 E Lohman Ave Las Cruces, NM - 880118267 |
| Business Phone Number: | 5752022713 |
| Business Fax Number: | |
| Mailing Address: | 2020 San Patricio Loop, LAS CRUCES |
| State: | NM |
| Postal Code: | 880114203 |
| Phone Number: | 5752022713 |
| Fax Number: | |
| NPI Enumeration Date: | 10/27/2010 |
| NPI Last Update Date: | 10/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 4714 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |