Provider Demographics
NPI:1265770200
Name:MARTINEZ, ARIEL EFRAIN (SOCIAL WORKER)
Entity type:Individual
Prefix:MR
First Name:ARIEL
Middle Name:EFRAIN
Last Name:MARTINEZ
Suffix:
Gender:M
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. REGIONAL
Mailing Address - Street 2:CALLE 11 # L-2
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-356-4221
Mailing Address - Fax:
Practice Address - Street 1:URB. REGIONAL
Practice Address - Street 2:CALLE 11 # L-2
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-7207
Practice Address - Country:US
Practice Address - Phone:787-356-4221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR51021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical