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General NPI Number Information
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NPI Number | 1790053155
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Entity Type | Organization
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Legal Business Name | GLENDA MARTINEZ, PH.D,, P.A.
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 3408 W 84TH ST STE 310
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City | HIALEAH
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State | FL
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Zip | 33018-4944
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Country | US
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Telephone | 305-826-6969
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Fax |
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Provider Business Mailing Address
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Address Line | 3408 W 84TH ST STE 310
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City | HIALEAH
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State | FL
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Zip | 33018-4944
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Country | US
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Telephone | 305-826-6969
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. GLENDA MARTINEZ
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Credential | PH.D.
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Telephone | 305-826-6969
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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 |
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License Number State |
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