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Individual

MRS. LATASHA MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ED.S, LPC

Contact information

Practice address
136-4 FORUM DRIVE, SUITE 170, COLUMBIA, SC 29229
(803) 200-2333
(803) 877-1036
Mailing address
136-4 FORUM DRIVE, SUITE 170, COLUMBIA, SC 29229
(803) 200-2333
(803) 877-1036

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5243
SC

Other

Enumeration date
03/01/2011
Last updated
04/22/2022
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