Individual
MS. MAXINE MARTINIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
321 CLAY ST SPC 63, ASHLAND, OR 97520-7379
(541) 708-7755
Mailing address
PO BOX 1172, ASHLAND, OR 97520-0040
(541) 708-7755
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
OR T0846
OR
Other
Enumeration date
06/15/2014
Last updated
06/15/2014
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