Provider Demographics
NPI:1316525256
Name:MARTINEZ, GRECIA (SLPA)
Entity type:Individual
Prefix:
First Name:GRECIA
Middle Name:
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6416 W SUNNYSLOPE LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-4020
Mailing Address - Country:US
Mailing Address - Phone:213-309-0458
Mailing Address - Fax:
Practice Address - Street 1:6416 W SUNNYSLOPE LN
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4020
Practice Address - Country:US
Practice Address - Phone:213-309-0458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA128862355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant