Provider Demographics
NPI:1558143842
Name:MARTINEZ GUZMAN, ADELMARYS (LICENSED SOCIAL WORK)
Entity Type:Individual
Prefix:
First Name:ADELMARYS
Middle Name:
Last Name:MARTINEZ GUZMAN
Suffix:
Gender:F
Credentials:LICENSED SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLA UNIVERSITARIA
Mailing Address - Street 2:CALLE 29 BD17
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:939-287-3530
Mailing Address - Fax:
Practice Address - Street 1:VILLA UNIVERSITARIA
Practice Address - Street 2:CALLE 29 BD17
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:939-287-3530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25148104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker