Provider Demographics
NPI:1922264811
Name:MARTINEZ, DORA MOLINA
Entity Type:Individual
Prefix:MS
First Name:DORA
Middle Name:MOLINA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 W BRICHTA DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1868
Mailing Address - Country:US
Mailing Address - Phone:520-225-1100
Mailing Address - Fax:
Practice Address - Street 1:2110 W BRICHTA DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-1868
Practice Address - Country:US
Practice Address - Phone:520-225-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool