Healthcare Provider Details

I. General information

NPI: 1356528335
Provider Name (Legal Business Name): BELINDA D MARTINEZ SW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6316 CONSTITUTION AVE NE MARK TWAIN ES
ALBUQUERQUE NM
87110-5944
US

IV. Provider business mailing address

6316 CONSTITUTION AVE NE MARK TWAIN ES
ALBUQUERQUE NM
87110-5944
US

V. Phone/Fax

Practice location:
  • Phone: 505-255-8337
  • Fax:
Mailing address:
  • Phone: 505-255-8337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberM 6646
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: