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Individual
MATTHEW JOHN MARTENSON
Active
Individual
MATTHEW JOHN MARTENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSED, NCC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
087950
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275088114
—
IA
Enumeration date
08/21/2016
Last updated
01/17/2024
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