Individual
MS. ANNE LOUISE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA MFT
Contact information
Practice address
23861 EL TORO RD, 7TH FLOOR, LAKE FOREST, CA 92630-4732
(949) 900-8262
Mailing address
25882 VICAR WAY, LAKE FOREST, CA 92630-5926
(949) 306-9565
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
59308
CA
Other
Enumeration date
01/03/2011
Last updated
01/03/2011
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