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Individual
JENNIFER LEE MARTIN
Active
Individual
JENNIFER LEE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LMFT
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18899
TX
106H00000X
Marriage & Family Therapist
3030
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238896
TRICARE
TX
Enumeration date
01/18/2007
Last updated
07/30/2007
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