Individual
KEISHA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1931 J N PEASE PL, SUITE 202, CHARLOTTE, NC 28262-4544
(704) 258-1611
Mailing address
11000 GREENHEAD VIEW RD, CHARLOTTE, NC 28262-1669
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A11498
NC
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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