Individual
CAROLYN MARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 344-2323
(309) 344-4368
Mailing address
2323 WINDISH DR, GALESBURG, IL 61401-9780
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
150014404
IL
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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