Individual
DAVID EVAN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA LPC, LPCC
Contact information
Practice address
1330 E COOLEY DR, COLTON, CA 92324-3905
(405) 761-5493
Mailing address
555 TERRACINA BLVD, REDLANDS, CA 92373-5643
(405) 761-5493
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3808
CA
101YP2500X
Professional Counselor
4882
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPCC3808
BOARD OF BEHAVIORAL SCIENCES
CA
Enumeration date
05/18/2007
Last updated
03/11/2021
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