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General NPI Number Information
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NPI Number | 1730259854
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Entity Type | Individual
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Provider Name | DANA L MARTINEZ PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 03/30/2021
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Provider Practice Location Address
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Address Line | 25 CHURCH HILL RD
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City | NEWTOWN
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State | CT
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Zip | 06470
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Country | US
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Telephone | 203-232-2274
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Fax |
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Provider Business Mailing Address
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Address Line | 33 CHURCH HILL RD
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City | NEWTOWN
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State | CT
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Zip | 06470-1637
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Country | US
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Telephone | 203-232-2274
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2470
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License Number State | CT
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