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NPI Code Detail

MEDICARE: RAQUEL MARTINEZ

MEDICARE: RAQUEL MARTINEZ
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1770397572
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAQUEL MARTINEZ
Provider Business Mailing Address
First Line : 1081 LAMB CT SE
Second Line :
City : LOS LUNAS
State : NM
Zip : 87031-9221
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2600 PALMILLA RD NW
Second Line :
City : LOS LUNAS
State : NM
Zip : 87031-4864
Country : US
Telephone Number : 505-856-6880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2025
Last Update Date : 02/03/2025

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Directions to “ RAQUEL MARTINEZ ” Practice Location

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