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1245319003
FRED J MARTINEZ
ROCKFORD, IL
NPI
1245319003
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149-008217)
Enumeration Date
2006-11-03
Last Update Date
2007-07-08
Business Address
-- FRED J MARTINEZ LCSW
2823 GLENWOOD AVE
ROCKFORD, IL 61101-3542
Phone number: 815-968-5342
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Mailing Address
-- FRED J MARTINEZ LCSW
2823 GLENWOOD AVE
ROCKFORD, IL 61101-3542
Phone number: 815-968-5342
Copy
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