MEDICARE: MARITZA MARTINEZ-CHINCHILLA AND ASSOCIATES

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	101YP2500X	Professional Counselor	7954	TX

General Provider Information

NPI Number	:	1871926089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARITZA MARTINEZ-CHINCHILLA AND ASSOCIATES

Provider Business Mailing Address
First Line	:	991 BUOY RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-5119
Country	:	US
Telephone Number	:	832-646-5691
Fax Number	:

Provider Business Practice Location Address
First Line	:	991 BUOY RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77062-5119
Country	:	US
Telephone Number	:	832-646-5691
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MARITZA MARTINEZ-CHINCHILLA
Credential	:	LPC
Telephone Number	:	832-646-5691

Provider Enumeration Date	:	08/12/2013
Last Update Date	:	08/12/2013

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