Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PY8212 | FL |
Y | 103T00000X | Psychologist | PY8212 | FL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1134457914 |
---|---|
Provider Name | Dr. Grettel Martinez |
First Address | Miami, FL 33144-2206 |
Second Address | Miami, FL 33144-2206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2009 |
Last Update Date | 22/03/2021 |