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Individual
REBECCA LYNN MARTIN
Active
Individual
REBECCA LYNN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
58622
TX
104100000X
Social Worker
S.1100640
OH
1041C0700X
Clinical Social Worker
Primary
CW018294
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0210850
—
OH
05
—
1029617040013
—
PA
Enumeration date
09/12/2011
Last updated
09/14/2022
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