Healthcare Provider Details

I. General information

NPI: 1952714131
Provider Name (Legal Business Name): MARTINE HYLTON-SANDERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6436 FRANKLIN RIDGE DR
EL PASO TX
79912-8127
US

IV. Provider business mailing address

12647 OLIVE BLVD STE 600
SAINT LOUIS MO
63141-6346
US

V. Phone/Fax

Practice location:
  • Phone: 914-380-0034
  • Fax:
Mailing address:
  • Phone: 800-325-3982
  • Fax: 877-685-9880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number074453-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: