Provider Demographics
NPI:1912633751
Name:MARTINEZ, MARIANA SANTA
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:SANTA
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:URB VILLA BLANCA CALLE AQUAMARINA #68
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-744-4447
Mailing Address - Fax:787-988-7832
Practice Address - Street 1:URBANICACION VILLA BLANCA CALLE AQUAMARINA #68
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:787-744-4447
Practice Address - Fax:787-988-7832
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool