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NPI Code Detail

MEDICARE: CARLOS MIGUEL MARTINEZ LMFTA

MEDICARE: CARLOS MIGUEL MARTINEZ LMFTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistCTL10204341NM

General Provider Information

NPI Number : 1588221709
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLOS MIGUEL MARTINEZ LMFTA
Provider Business Mailing Address
First Line : 755 S TELSHOR BLVD STE Q102
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4681
Country : US
Telephone Number : 575-888-4666
Fax Number : 888-473-9160
Provider Business Practice Location Address
First Line : 755 S TELSHOR BLVD STE Q102
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4681
Country : US
Telephone Number : 575-888-4666
Fax Number : 888-473-9160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2019
Last Update Date : 05/22/2019

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Directions to “ CARLOS MIGUEL MARTINEZ LMFTA” Practice Location

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