Provider Demographics
NPI:1689166308
Name:MARTINEZ-MARCIULIONIS, ANDRIANA MARIA
Entity Type:Individual
Prefix:
First Name:ANDRIANA
Middle Name:MARIA
Last Name:MARTINEZ-MARCIULIONIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-3707
Mailing Address - Country:US
Mailing Address - Phone:775-624-8200
Mailing Address - Fax:
Practice Address - Street 1:1530 E 6TH ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-3707
Practice Address - Country:US
Practice Address - Phone:775-624-8200
Practice Address - Fax:775-624-8222
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner