Individual
MRS. EVA DIANE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
2920 MARIETTA HIGHWAY, SUITE 146, CANTON, GA 30114
(470) 253-7252
(800) 397-1710
Mailing address
2920 MARIETTA HIGHWAY, SUITE 146, CANTON, GA 30114
(470) 253-7252
(800) 397-1710
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC001690
GA
101YS0200X
School Counselor
LPC001690
GA
106H00000X
Marriage & Family Therapist
LPC001690
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003106189B
—
GA
Enumeration date
01/10/2011
Last updated
01/26/2015
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