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General NPI Number Information
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NPI Number | 1861047821
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Entity Type | Individual
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Provider Name | STEPHANIE ANNE MARTINEZ LGMFT
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Gender | Female
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Dates
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Enumeration Date | 08/07/2019
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Last Update Date | 08/07/2019
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Provider Practice Location Address
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Address Line | 5652 SHIELDS DR
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City | BETHESDA
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State | MD
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Zip | 20817-3574
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Country | US
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Telephone | 240-225-0522
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 N GARFIELD ST APT 442
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City | ARLINGTON
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State | VA
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Zip | 22201-2565
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Country | US
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Telephone | 915-346-6779
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LGM738
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License Number State | MD
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