Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 36853 | TX |
NPI | 1073991428 |
---|---|
Provider Name | Dr. Richard Aaron Martinez |
First Address | San Antonio, TX 78207-3205 |
Second Address | San Antonio, TX 78207-3205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2015 |
Last Update Date | 18/05/2015 |