Individual
MR. GARY J MARTIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6 DARTMOUTH AVE, RIVERSIDE, RI 02915-2627
(401) 339-2477
Mailing address
6 DARTMOUTH AVE, RIVERSIDE, RI 02915-2627
(401) 339-2477
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW02301
RI
Other
Enumeration date
04/09/2024
Last updated
04/09/2024
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