Individual
MS. PAULA KAYE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, LISAC
Contact information
Practice address
2500 E SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7929
(928) 537-1029
Mailing address
2832 VIEW WAY, LAKESIDE, AZ 85929-5549
(928) 242-8739
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-10642
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146952
AHCCCS
AZ
Enumeration date
05/31/2007
Last updated
07/08/2007
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