Provider Demographics
NPI:1841166709
Name:MARTINEZ, NASHDRA LEE (MA)
Entity type:Individual
Prefix:
First Name:NASHDRA
Middle Name:LEE
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 CALLE GUILLERMO RODRIGUEZ
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-9807
Mailing Address - Country:US
Mailing Address - Phone:787-202-3085
Mailing Address - Fax:
Practice Address - Street 1:462 CALLE GUILLERMO RODRIGUEZ
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-9807
Practice Address - Country:US
Practice Address - Phone:787-202-3085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8449103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool