Individual
DIANNE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLP, LPC, LMSW
Contact information
Practice address
2550 S TELEGRAPH RD, SUITE 250, BLOOMFIELD HILLS, MI 48302-0950
(248) 322-0001
(248) 322-0004
Mailing address
24670 LARGES DR, SOUTHFIELD, MI 48034-3220
(248) 356-5282
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401001795
MI
103TC0700X
Clinical Psychologist
6301008167
MI
Other
Enumeration date
04/23/2007
Last updated
09/11/2025
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