Individual
MARY EDNA WANDA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
819 LEE ROAD 219, PHENIX CITY, AL 36870-8723
(706) 761-6885
Mailing address
819 LEE ROAD 219, PHENIX CITY, AL 36870-8723
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1869C
AL
1041C0700X
Clinical Social Worker
Primary
CSW005133
GA
Other
Enumeration date
09/29/2025
Last updated
09/29/2025
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