Individual
MIA MARTANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COUNSELOR
Contact information
Practice address
526 OLD LIVERPOOL RD STE 9, LIVERPOOL, NY 13088-6285
(315) 453-3911
Mailing address
3774 STATE ROUTE 31 APT 612, LIVERPOOL, NY 13090-1362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/03/2020
Last updated
08/02/2021
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