Individual
MRS. MARTHA KINMAN FAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW CMHP
Contact information
Practice address
5050 OCEAN BEACH BLVD APT 103, COCOA BEACH, FL 32931-3762
(321) 323-9302
(888) 354-4711
Mailing address
5050 OCEAN BEACH BLVD APT 103, COCOA BEACH, FL 32931-3762
(321) 323-9302
(888) 354-4711
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW4370
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7675437 00
—
FL
Enumeration date
06/26/2008
Last updated
01/08/2022
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