Individual
THOMAS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-4360
(920) 437-3540
Mailing address
300 CROOKS ST, GREEN BAY, WI 54301-4527
(920) 436-4360
(920) 437-3540
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
77-123
WI
Other
Enumeration date
04/09/2008
Last updated
06/04/2009
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