Individual
AMANDA LYN MARTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
644 N 2ND ST STE 4, BREESE, IL 62230-1614
(314) 881-8135
Mailing address
45 NORTHVIEW DR, HIGHLAND, IL 62249-1077
(618) 623-9148
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
178.015105
IL
Other
Enumeration date
01/03/2019
Last updated
08/19/2019
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