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1477082246
HAILEY NICOLE MARTINEZ
AMMON, ID
NPI
1477082246
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID LCPC-6402)
Enumeration Date
2017-06-06
Last Update Date
2017-06-06
Business Address
Mrs. HAILEY NICOLE MARTINEZ PhD, LCPC
2705 E 17TH ST
AMMON, ID 83406-6601
Phone number: 208-346-7500
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Mailing Address
Mrs. HAILEY NICOLE MARTINEZ PhD, LCPC
1979 GRANDVIEW AVE
POCATELLO, ID 83204-3655
Phone number: 208-241-0173
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