Individual
MARY MICHELLE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
711 N BEAVER ST, FLAGSTAFF, AZ 86001
(928) 216-4868
Mailing address
711 N BEAVER ST, FLAGSTAFF, AZ 86001-3103
(928) 216-4868
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-23115
AZ
Other
Enumeration date
06/07/2024
Last updated
01/27/2025
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