Provider Demographics
NPI:1225642317
Name:MARTINEZ, REBECA (LPC)
Entity Type:Individual
Prefix:
First Name:REBECA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB FLAMBOYAN GARDENS
Mailing Address - Street 2:K6 CALLE 13
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-5810
Mailing Address - Country:US
Mailing Address - Phone:939-232-0570
Mailing Address - Fax:
Practice Address - Street 1:URB FLAMBOYAN GARDENS
Practice Address - Street 2:K6 CALLE 13
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5810
Practice Address - Country:US
Practice Address - Phone:939-232-0570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional