Individual
MRS. JODIE A MARTENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7143-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39798400
—
WI
01
—
7143-123
LICENSE
WI
Enumeration date
11/05/2007
Last updated
07/06/2018
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