Individual
DANIEL PHILLIP MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
91 W COLT SQUARE DR STE 4, FAYETTEVILLE, AR 72703-2846
(479) 629-5519
Mailing address
91 W COLT SQUARE DR STE 4, FAYETTEVILLE, AR 72703-2846
(479) 629-5519
(479) 316-2904
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
10158M
AR
1041C0700X
Clinical Social Worker
Primary
10158-C
AR
Other
Enumeration date
08/25/2020
Last updated
01/29/2024
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