Provider Demographics
NPI:1174358105
Name:MARTINEZ BLEVINS, EMILY (LMSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MARTINEZ BLEVINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6128 E 38TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5832
Mailing Address - Country:US
Mailing Address - Phone:918-313-5034
Mailing Address - Fax:
Practice Address - Street 1:6128 E 38TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5832
Practice Address - Country:US
Practice Address - Phone:918-313-5034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9179104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker