Provider Demographics
NPI:1881685683
Name:WHITE MARTINEZ, JOY REBECCA (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:REBECCA
Last Name:WHITE MARTINEZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JOY
Other - Middle Name:REBECCA
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:711 S COWLEY ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1330
Mailing Address - Country:US
Mailing Address - Phone:509-473-6896
Mailing Address - Fax:
Practice Address - Street 1:711 S COWLEY ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1330
Practice Address - Country:US
Practice Address - Phone:509-473-6896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002830103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation