Provider Demographics
NPI:1114326329
Name:MARTINS, GRAZIELLA (LCSW)
Entity Type:Individual
Prefix:
First Name:GRAZIELLA
Middle Name:
Last Name:MARTINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 E GLENN ST APT 99
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-5227
Mailing Address - Country:US
Mailing Address - Phone:612-240-6594
Mailing Address - Fax:
Practice Address - Street 1:5675 N ORACLE RD
Practice Address - Street 2:SUITE 3101
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-3885
Practice Address - Country:US
Practice Address - Phone:520-419-6636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ151131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical