Organization
CHARLES R. MARTIN, PH.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES R MARTIN PH.D. (PRESIDENT)
(352) 375-7756
Entity
Organization
Contact information
Practice address
2631 NW 41ST ST, E-6, GAINESVILLE, FL 32606-7470
(352) 375-7756
Mailing address
2631 NW 41ST ST, E-6, GAINESVILLE, FL 32606-7470
(352) 375-7756
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PY5214
FL
Other
Enumeration date
12/29/2016
Last updated
12/29/2016
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