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Individual

MRS. KATHLEEN ELLEN MARTIN IX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
26184 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 389-7532
(313) 389-2956
Mailing address
31528 SHERIDAN ST, GARDEN CITY, MI 48135-3341
(734) 422-1591

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704092451
MI

Other

Enumeration date
06/07/2007
Last updated
07/08/2007
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