Provider Demographics
NPI:1780960740
Name:MARTINEZ, ANA FELISA (LMSW IPR)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:FELISA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:LMSW IPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 TERESA AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1826
Mailing Address - Country:US
Mailing Address - Phone:956-467-8866
Mailing Address - Fax:
Practice Address - Street 1:3100 TERESA AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1826
Practice Address - Country:US
Practice Address - Phone:956-467-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21699171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator