Individual
MR. CHARLES HAROLD MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-BACS
Contact information
Practice address
4739 HWY 10, JACKSON, LA 70748
(225) 634-0094
(225) 634-0094
Mailing address
4739 HWY 10, JACKSON, LA 70748
(225) 634-0094
(225) 634-0094
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4250
LA
Other
Enumeration date
03/05/2010
Last updated
03/05/2010
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