Individual
JESSE PAUL MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, NCC
Contact information
Practice address
1470 E MAIN ST, ANNVILLE, PA 17003-1613
(717) 964-7090
Mailing address
351 FONTANA AVE, LEBANON, PA 17042-4718
(717) 269-0414
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
PC013781
PA
101YP2500X
Professional Counselor
Primary
PC013781
PA
Other
Enumeration date
10/04/2021
Last updated
02/01/2024
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