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General NPI Number Information
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NPI Number | 1457171019
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Entity Type | Individual
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Provider Name | MS. GABRIELLE MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 1817 WELLSPRING AVE SE SUITE D, RIO RANCHO NM 87124
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City | RIO RANCHO
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State | NM
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Zip | 87124
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Country | US
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Telephone | 505-828-3837
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Fax | 877-828-1550
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Provider Business Mailing Address
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Address Line | 8100 WYOMING BLVD NE #406 M-, ALBUQUERQUE, NM 87113
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City | ALBUQUERQUE
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State | NM
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Zip | 87113
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Country | US
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Telephone | 505-715-4610
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | NM
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