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Organization

FAMILY THERAPY AND WELLNESS CONSULTING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICHARD GRANT MARTIN MA, LPC, LMFT (OWNER)
(318) 469-9132
Entity
Organization

Contact information

Practice address
418 WEBB CT, MINDEN, LA 71055-2649
(318) 371-2714
Mailing address
418 WEBB CT, MINDEN, LA 71055-2649

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
2032
LA
305S00000X
Point of Service
Primary
2032
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
137
MARRIAGE AND FAMILY THERAPIST
LA
Enumeration date
01/28/2016
Last updated
01/28/2016
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