Most Relevant Information
Provider Data
| NPI Number: | 1003419813 |
| Provider Name: | MARTINA CARRENO |
| Entity Type: | Individual |
| Taxonomy Code: | 222Q00000X |
| Specialty: | Developmental Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/16/2020 |
| Last Updated: | 11/16/2020 |
Provider Practice Location
21828 W WHITEHALL CT
ANTIOCH
IL
600029313
Practice Location Phone/Fax
| Phone: | 7864442310 |
| Fax: |
Provider Mailing Location
21828 W WHITEHALL CT
ANTIOCH
IL
600029313
Provider Mailing Phone/Fax
| Phone: | 7864442310 |
| Fax: |