Individual
MRS. MARY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4595
(662) 680-6416
Mailing address
2434 S EASON BLVD, TUPELO, MS 38804-6942
(662) 640-4595
(662) 680-6416
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
M6986
MS
1041C0700X
Clinical Social Worker
Primary
C-6986
MS
Other
Enumeration date
01/06/2014
Last updated
09/04/2025
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