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General NPI Number Information
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NPI Number | 1053973511
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Entity Type | Individual
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Provider Name | LISANDRA MARTINEZ MSW
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Gender | Female
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Dates
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Enumeration Date | 07/05/2019
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 35 CALLE MAYOR
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City | PONCE
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State | PR
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Zip | 00730-3726
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Country | US
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Telephone | 787-844-3077
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Fax | 787-844-3077
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Provider Business Mailing Address
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Address Line | PO BOX 8851
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City | PONCE
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State | PR
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Zip | 00732-8851
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Country | US
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Telephone | 787-844-3077
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Fax | 787-844-3077
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 8775
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14024
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License Number State | PR
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