Provider Demographics
NPI:1477171296
Name:MARTINEZ, SANDRA NOHEMI (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:NOHEMI
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5499 FOX HILL RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7761
Mailing Address - Country:US
Mailing Address - Phone:956-624-5294
Mailing Address - Fax:
Practice Address - Street 1:9800 JUG ST NW
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-8691
Practice Address - Country:US
Practice Address - Phone:740-924-7543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS-1803192104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker