Individual
JOE DAVIS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1212 W LOMBARD ST, SPRINGFIELD, MO 65806-2720
(417) 865-1646
Mailing address
2154 N VICTORIA LN, BROOKLINE STA, MO 65619-9551
(417) 619-2875
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2001007817
MO
Other
Enumeration date
08/29/2008
Last updated
08/29/2008
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