MEDICARE: MISS JANETTE MARTINEZ CRIMINAL JUSTICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	101YA0400X	Addiction (Substance Use Disorder) Counselor		NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669831384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JANETTE MARTINEZ CRIMINAL JUSTICE

Provider Business Mailing Address
First Line	:	1810 E SAHARA AVE STE 112
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3707
Country	:	US
Telephone Number	:	702-738-6230
Fax Number	:	702-472-8619

Provider Business Practice Location Address
First Line	:	1785 E SAHARA AVE STE 340
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3717
Country	:	US
Telephone Number	:	702-433-0063
Fax Number	:	702-433-0593

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2016
Last Update Date	:	08/13/2024

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Directions to “ MISS JANETTE MARTINEZ CRIMINAL JUSTICE” Practice Location

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