Individual
ANGELA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4536 22ND AVE, KENOSHA, WI 53140-5917
(262) 656-0044
(262) 764-3636
Mailing address
625 57TH ST, SUITE 700, KENOSHA, WI 53140-4146
(262) 656-0044
(262) 764-3636
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5462-125
WI
Other
Enumeration date
12/05/2014
Last updated
12/05/2014
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