Individual
WILLIAM BLAKE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
708 W SUMMIT AVE, SAN ANTONIO, TX 78212-2746
(210) 239-7715
Mailing address
5900 BALCONES DR STE 100, AUSTIN, TX 78731-4298
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
39616
TX
Other
Enumeration date
05/29/2023
Last updated
05/29/2023
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