Individual
AUDRA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD,LISW-S
Contact information
Practice address
116 CLEVELAND AVE NW STE 555, CANTON, OH 44702-1749
(330) 915-8347
Mailing address
116 CLEVELAND AVE NW STE 555, CANTON, OH 44702-1749
(330) 915-8347
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
I.1440233-SUPV
OH
1041C0700X
Clinical Social Worker
Primary
I.1440233-SUPV
OH
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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