Individual
MINNIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
2318 E CENTRAL AVE, WICHITA, KS 67214-4436
(316) 262-2415
(316) 262-0318
Mailing address
2318 E CENTRAL AVE, WICHITA, KS 67214-4436
(316) 262-2415
(316) 262-0318
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1249
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044590
BCBS
KS
05
—
100212200B
—
KS
01
—
N819
PREFERRED HEALTH SYSTEMS
KS
Enumeration date
09/22/2006
Last updated
03/25/2021
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