Individual
BAMBI RAE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
314 S. BROADWAY, SUITE 106, ADA, OK 74820
(580) 235-0210
(580) 235-0211
Mailing address
112 W. MAIN, PURCELL, OK 73080
(405) 527-1785
(405) 527-1084
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
3849
OK
Other
Enumeration date
03/30/2007
Last updated
10/29/2010
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