Provider Demographics
NPI:1053136028
Name:MARTINEZ, MARITZA ALVARADO
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:ALVARADO
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14535 W INDIAN SCHOOL RD STE 120
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-9282
Mailing Address - Country:US
Mailing Address - Phone:623-738-5160
Mailing Address - Fax:
Practice Address - Street 1:14535 W INDIAN SCHOOL RD STE 120
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-9282
Practice Address - Country:US
Practice Address - Phone:623-335-2290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-23101101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor