Provider Demographics
NPI:1609659309
Name:MARTINEZ, MARIA FERNANDA (BS, SLP-ASSISTANT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:FERNANDA
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:BS, SLP-ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 N JACKSON RD STE 900
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-5764
Mailing Address - Country:US
Mailing Address - Phone:956-661-0475
Mailing Address - Fax:
Practice Address - Street 1:1201 N JACKSON RD STE 900
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5764
Practice Address - Country:US
Practice Address - Phone:956-661-0475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX428082355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant