Provider Demographics
NPI:1821238403
Name:MARTINEZ, RITA A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:A
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:MARTINEZ
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6303 CAIRO DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5209
Mailing Address - Country:US
Mailing Address - Phone:210-394-4732
Mailing Address - Fax:210-499-4951
Practice Address - Street 1:19206 HUEBNER RD STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3146
Practice Address - Country:US
Practice Address - Phone:210-394-4732
Practice Address - Fax:210-499-4951
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX395961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical