Individual
MS. ANGELA MARIA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
12225 71ST ST, KENOSHA, WI 53142-7320
(877) 666-7223
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(877) 666-7223
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6568
WI
1041C0700X
Clinical Social Worker
Primary
6568-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39746200
—
WI
Enumeration date
12/12/2006
Last updated
02/21/2024
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