Provider Demographics
NPI:1407348501
Name:MARTINEZ LOMBARDY, DINA MARIA (MS, QMHP, QMRP)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:MARIA
Last Name:MARTINEZ LOMBARDY
Suffix:
Gender:F
Credentials:MS, QMHP, QMRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8154
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22404-8154
Mailing Address - Country:US
Mailing Address - Phone:540-661-2906
Mailing Address - Fax:
Practice Address - Street 1:6506 FOREST GROVE DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407
Practice Address - Country:US
Practice Address - Phone:540-661-2906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-04
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171R00000XOther Service ProvidersInterpreter