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General NPI Number Information
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NPI Number | 1982166575
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Entity Type | Individual
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Provider Name | ERIN KATHARINE MARTINEZ LMSW
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Gender | Female
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 224 W DL INGRAM
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City | CANNON AIR FORCE BASE
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State | NM
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Zip | 88101
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Country | US
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Telephone | 575-781-1108
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Fax |
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Provider Business Mailing Address
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Address Line | 224 WEST DL INGRAM AVE
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City | CANNON AIR FORCE BASE
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State | NM
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Zip | 88101-5508
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Country | US
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Telephone | 575-784-1108
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-11287
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 011700
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | M-010234
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License Number State | NM
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