Individual
ANTOINETTE MARIE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TCADC
Contact information
Practice address
10235 RIVERSTONE CIR, LOUISVILLE, KY 40229-5228
(502) 975-9412
Mailing address
4621 OUTER LOOP STE 175, LOUISVILLE, KY 40219-3970
(502) 431-3073
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
282757
KY
171M00000X
Case Manager/Care Coordinator
Primary
—
KY
Other
Enumeration date
04/19/2023
Last updated
05/12/2026
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