Individual
CONNIE MAY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, BA
Contact information
Practice address
620 E COURT ST, ATOKA, OK 74525-3016
(580) 364-0170
Mailing address
901 W 8TH ST, ADA, OK 74820-4809
(580) 399-0200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/23/2008
Last updated
10/18/2012
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