Individual
MELINDA EVELYN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
1523 LONGBRANCH AVE, GROVER BEACH, CA 93433-2508
(805) 473-7081
Mailing address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4558
(805) 781-4275
(805) 781-1227
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
37000
CA
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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