Individual
ELIZABETH MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
3721 ORION DR, LA MESA, CA 91941-8027
(802) 505-5963
Mailing address
3721 ORION DR, LA MESA, CA 91941-8027
(802) 505-5963
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP9096
AZ
Other
Enumeration date
10/08/2014
Last updated
04/13/2021
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