Individual
COURTNEY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 E SOUTH BLVD, PETERSBURG, VA 23805-2700
(980) 328-3524
Mailing address
255 E SOUTH BLVD, PETERSBURG, VA 23805-2700
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
PPS-0606107
VA
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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