Individual
GRETCHEN LEE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
8609 LYNDALE AVE S STE 210, BLOOMINGTON, MN 55420-2754
(952) 807-1095
Mailing address
6820 CARDINAL COVE DR # 9534, MINNETRISTA, MN 55364-9534
(952) 807-1095
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PRE-LICENSED
MN
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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