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General NPI Number Information
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NPI Number | 1336880640
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Entity Type | Individual
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Provider Name | YADALIS Z MARTINEZ LMSW
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Gender | Female
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Dates
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Enumeration Date | 04/02/2022
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Last Update Date | 04/02/2022
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Provider Practice Location Address
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Address Line | 603 HADECO DR
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City | LORDSBURG
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State | NM
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Zip | 88045-1813
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Country | US
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Telephone | 575-542-8447
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Fax | 575-542-8447
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Provider Business Mailing Address
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Address Line | 1311 N GRANT ST STE A
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City | SILVER CITY
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State | NM
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Zip | 88061-5134
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Country | US
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Telephone | 575-388-1447
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Fax | 575-388-1447
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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 | X-12352
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License Number State | NM
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