Individual
KEONNA JANEEN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2927 N 5TH ST, SUITE 103, PHILADELPHIA, PA 19133-2800
(215) 634-6400
(215) 634-8978
Mailing address
2927 N 5TH ST, SUITE 103, PHILADELPHIA, PA 19133-2800
(215) 634-6400
(215) 634-8978
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/08/2010
Last updated
03/12/2010
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