Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003341561 |
---|---|
Provider Name | Aldwis Martinez |
First Address | Lawrence, MA 01841-2831 |
Second Address | Lawrence, MA 01841-2831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2017 |
Last Update Date | 21/04/2017 |