Provider Demographics
NPI:1790260271
Name:MARTINEZ, EMILY MARIE (MS)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:MARIE
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21300 RUTH AND BARON COLEMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:BACA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428
Mailing Address - Country:US
Mailing Address - Phone:954-278-4430
Mailing Address - Fax:
Practice Address - Street 1:21300 RUTH AND BARON COLEMAN BLVD
Practice Address - Street 2:
Practice Address - City:BACA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428
Practice Address - Country:US
Practice Address - Phone:954-278-4430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-01
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty