Individual
DOMINIQUE M MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIMFT
Contact information
Practice address
399 E MAIN ST, COLUMBUS, OH 43215-5384
(614) 355-8550
(614) 355-8593
Mailing address
DEPT 781625, DETROIT, MI 48278-1625
(614) 355-8004
(614) 355-2220
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
F.1800067
OH
106H00000X
Marriage & Family Therapist
M.1600007
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
03/29/2016
Last updated
04/05/2019
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