Provider Demographics
NPI:1679220495
Name:MARTINEZ LABOY, NAHOMI (MS)
Entity Type:Individual
Prefix:MRS
First Name:NAHOMI
Middle Name:
Last Name:MARTINEZ LABOY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 BLVD MEDIA LUNA APT 4501
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-4946
Mailing Address - Country:US
Mailing Address - Phone:407-473-9312
Mailing Address - Fax:
Practice Address - Street 1:79 BLVD MEDIA LUNA APT 4501
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-4946
Practice Address - Country:US
Practice Address - Phone:407-473-9312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6826103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling