Provider Demographics
NPI:1639836539
Name:MARTINEZ-MOLINA, YAMISEL (LPC)
Entity Type:Individual
Prefix:
First Name:YAMISEL
Middle Name:
Last Name:MARTINEZ-MOLINA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 RIDGE PIKE APT 211B
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1917
Mailing Address - Country:US
Mailing Address - Phone:717-769-7049
Mailing Address - Fax:
Practice Address - Street 1:752 WILLOW ST STE G
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17046-5066
Practice Address - Country:US
Practice Address - Phone:484-269-6572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-26
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC013887101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional