Doctor Name: | MELISSA LINN MARTINEZ |
NPI Number: | 1508208364 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 2527 |
Business Practice Address: | 404 N Baughman St Ulysses, KS - 678802058 |
Business Phone Number: | 6203563198 |
Business Fax Number: | 6203563101 |
Mailing Address: | 404 N Baughman St, ULYSSES |
State: | KS |
Postal Code: | 678802058 |
Phone Number: | 6203563198 |
Fax Number: | 6203563101 |
NPI Enumeration Date: | 07/22/2013 |
NPI Last Update Date: | 07/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2527 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |