Individual
MS. ANDREA JAYNE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1110 COLLEGE DR STE 206, BISMARCK, ND 58501-1207
(701) 258-2008
(701) 223-9114
Mailing address
1110 COLLEGE DR STE 206, BISMARCK, ND 58501-1207
(701) 258-2008
(701) 223-9114
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
260-1-1-93-51
ND
101YP2500X
Professional Counselor
Primary
260-1-1-93-51
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1463767
—
ND
Enumeration date
09/16/2006
Last updated
06/09/2021
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