Provider Demographics
NPI:1821479940
Name:MARTINEZ GUZMAN, DENISSE M (MSW)
Entity Type:Individual
Prefix:
First Name:DENISSE
Middle Name:M
Last Name:MARTINEZ GUZMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111-7 CALLE RAMAL
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669
Mailing Address - Country:US
Mailing Address - Phone:787-904-2794
Mailing Address - Fax:
Practice Address - Street 1:2 CALLE BALDORIOTY
Practice Address - Street 2:12 ESQ. C/GEORGETTI
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5072
Practice Address - Country:US
Practice Address - Phone:787-884-5975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR114811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical