Individual
JESSAMINE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2595 INTERSTATE DR STE 103, HARRISBURG, PA 17110-9378
(800) 370-3651
Mailing address
1480 BOSTON POST RD, OLD SAYBROOK, CT 06475-1750
(800) 370-3651
(877) 515-7147
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
10865
NE
103TC0700X
Clinical Psychologist
Primary
PS018877
PA
Other
Enumeration date
05/25/2016
Last updated
03/25/2021
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