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General NPI Number Information
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NPI Number | 1043014871
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Entity Type | Individual
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Provider Name | LAURA MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 312 N BROADWAY ST
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City | TRUTH OR CONSEQUENCES
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State | NM
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Zip | 87901-2834
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Country | US
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Telephone | 575-297-0157
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Fax |
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Provider Business Mailing Address
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Address Line | 5783 CREST RD
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City | SANTA TERESA
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State | NM
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Zip | 88008-9517
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Country | US
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Telephone | 915-204-2443
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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