Provider Demographics
NPI:1659676559
Name:MARTINEZ-FISHER, ANDREA LYNDA (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNDA
Last Name:MARTINEZ-FISHER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 3RD ST SW
Mailing Address - Street 2:UNIT C
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-4491
Mailing Address - Country:US
Mailing Address - Phone:505-401-8801
Mailing Address - Fax:
Practice Address - Street 1:1215 3RD ST SW
Practice Address - Street 2:UNIT C
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-4491
Practice Address - Country:US
Practice Address - Phone:505-401-8801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4276235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist