Provider Demographics
NPI:1487491049
Name:MARTINEZ-GUZMAN, LORNA SOFIA (PSYD, HSPP)
Entity type:Individual
Prefix:DR
First Name:LORNA
Middle Name:SOFIA
Last Name:MARTINEZ-GUZMAN
Suffix:
Gender:F
Credentials:PSYD, HSPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E 91ST ST STE 316
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1556
Mailing Address - Country:US
Mailing Address - Phone:317-550-3221
Mailing Address - Fax:317-550-3228
Practice Address - Street 1:50 E 91ST ST STE 316
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1556
Practice Address - Country:US
Practice Address - Phone:317-550-3221
Practice Address - Fax:317-550-3228
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20043785B103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical