Provider Demographics
NPI:1972111078
Name:LEMUS-MARTINEZ, DANIELA ELIZABET
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:ELIZABET
Last Name:LEMUS-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 1:75 GRAND AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3522
Mailing Address - Country:US
Mailing Address - Phone:201-962-6443
Mailing Address - Fax:
Practice Address - Street 1:75 GRAND AVE FL 1
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-3522
Practice Address - Country:US
Practice Address - Phone:201-962-6443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor