Individual
KENNETH LEON MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
105 PACES BROOK AVE, #10518, COLUMBIA, SC 29212-1642
(803) 467-4125
(803) 497-3920
Mailing address
105 PACES BROOK AVE, APT 10518, COLUMBIA, SC 29212-1642
(803) 467-4125
(803) 497-3920
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4941
SC
Other
Enumeration date
10/25/2006
Last updated
09/06/2011
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