Provider Demographics
NPI:1790778157
Name:MARTINEZ, RODMAN
Entity Type:Individual
Prefix:MR
First Name:RODMAN
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NORTH 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17046
Mailing Address - Country:US
Mailing Address - Phone:717-273-1710
Mailing Address - Fax:717-273-1416
Practice Address - Street 1:146 S 5TH ST
Practice Address - Street 2:PENNSYLVANIA COUNSELING SERVICES - PONCE
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602
Practice Address - Country:US
Practice Address - Phone:610-320-5440
Practice Address - Fax:610-320-5442
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health