Provider Demographics
NPI:1548962830
Name:MARTINEZ SANCHEZ, BRENDA LISETTE (SW)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LISETTE
Last Name:MARTINEZ SANCHEZ
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE EDDIE GRACIA
Mailing Address - Street 2:NUM 525 ROOSEVELT
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:786-219-8730
Mailing Address - Fax:
Practice Address - Street 1:MARGINAL SANTA CRUZ
Practice Address - Street 2:C 17 URB SANTA CRUZ
Practice Address - City:BAYAMON
Practice Address - State:RI
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-780-1273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9034104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker