Individual
KHALIL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
8080 OLD YORK RD, ELKINS PARK, PA 19027-1421
(267) 626-2018
Mailing address
608 MAPLE AVE, PHILADELPHIA, PA 19116-1702
(215) 353-0494
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SW137567
PA
104100000X
Social Worker
Primary
SW137567
PA
Other
Enumeration date
02/10/2021
Last updated
11/01/2023
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