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Individual

CAROL R MARTENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
721 SHERIDAN AVE, CODY, WY 82414-3423
(307) 578-2288
Mailing address
721 SHERIDAN AVE, CODY, WY 82414-3423
(307) 578-2288

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-680
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPC-680
STATE LICENSE
WY
Enumeration date
06/07/2007
Last updated
07/08/2007
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