Individual
MS. HEATHER LYNN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
801 EMPIRE ST, FAIRFIELD, CA 94533-5702
(707) 425-5744
Mailing address
801 EMPIRE ST, FAIRFIELD, CA 94533-5702
(707) 425-5744
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY30618
CA
103TC0700X
Clinical Psychologist
2012807
CA
225C00000X
Rehabilitation Counselor
2012807
CA
Other
Enumeration date
07/17/2013
Last updated
01/02/2019
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