Smith-Martinez, Kimberly Lisa

Smith-Martinez, Kimberly Lisa is an individual health care provider with primary practice located at 110 S Euclid Ave , Oak Park IL 60302-2906. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Smith-Martinez, Kimberly Lisa can be contacted via phone (210) 854-6786.

Contact Information

Primary practice address
110 S Euclid Ave Oak Park IL 60302-2906
Phone: (210) 854-6786
Fax: (708) 613-5254
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 30587 Texas
Behavioral Health & Social Service Providers / Psychologist 103T00000X 071.008583 Illinois

Profile Details

NPI number 1871667980
LBN Legal business name Smith-Martinez, Kimberly Lisa
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2006
Last updated Dec 2nd, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871667980 NPPES
Texas MEDICAID 040555701

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