Individual
JILL MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLPC, CAAC
Contact information
Practice address
31993 W 12 MILE RD, 311, FARMINGTON HILLS, MI 48334-3630
(248) 854-5158
Mailing address
31993 W 12 MILE RD, 311, FARMINGTON HILLS, MI 48334-3630
(248) 854-5158
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401010625
MI
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C-00413
MI
Other
Enumeration date
03/08/2010
Last updated
08/30/2022
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