Individual
PHYLLIS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1301 SUMMIT ST, MARSHALLTOWN, IA 50158-5484
(641) 753-4518
(641) 753-4203
Mailing address
2755 COMMERCIAL ST SE, # 101-258, SALEM, OR 97302-4981
(503) 896-0297
(503) 470-1108
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3028
OR
Other
Enumeration date
11/02/2006
Last updated
12/12/2019
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