Individual
ALYSSA NATALIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RADT
Contact information
Practice address
20331 FLANAGAN ROAD, TRABUCO CANYON, CA 92679
(818) 582-8832
(818) 582-8836
Mailing address
24016 ELROND LN, LAKE FOREST, CA 92630-3649
(949) 520-8855
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1396230720
CA
Other
Enumeration date
06/11/2020
Last updated
11/17/2020
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