Individual
MRS. CAROLE ELAINE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
4480 GRETNA RD, BRANSON, MO 65616-7202
(417) 761-5492
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2006038266
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494239809
—
MO
Enumeration date
05/17/2010
Last updated
07/26/2022
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