Provider Demographics
NPI:1609071893
Name:MARTINEZ, ANGEL MARIE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:MARIE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13297 SW 91ST PL
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34432-3716
Mailing Address - Country:US
Mailing Address - Phone:352-465-6078
Mailing Address - Fax:
Practice Address - Street 1:1207 SE 16TH ST.
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4601
Practice Address - Country:US
Practice Address - Phone:352-351-9999
Practice Address - Fax:352-351-9999
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7139101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health