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General NPI Number Information
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NPI Number | 1881005312
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Entity Type | Individual
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Provider Name | CRISTY MARTINEZ LPC
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Gender | Female
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Dates
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Enumeration Date | 05/19/2014
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Last Update Date | 01/09/2021
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Provider Practice Location Address
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Address Line | 4601 50TH ST STE 107A
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City | LUBBOCK
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State | TX
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Zip | 79414-3514
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Country | US
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Telephone | 806-553-6068
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Fax |
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Provider Business Mailing Address
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Address Line | 7102 ALCOVE AVE APT 405
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City | WOLFFORTH
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State | TX
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Zip | 79382-9755
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Country | US
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Telephone | 806-781-8169
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 79545
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License Number State | TX
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