Provider Demographics
NPI:1558059519
Name:MARTINEZ SANCHEZ, TAMARA D
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:D
Last Name:MARTINEZ SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 SW 33RD TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-7819
Mailing Address - Country:US
Mailing Address - Phone:239-922-8329
Mailing Address - Fax:
Practice Address - Street 1:412 SW 33RD TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-7819
Practice Address - Country:US
Practice Address - Phone:239-922-8329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst