Individual
MS. MICHELE RENEE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7460 TIDEWATER DR, NORFOLK, VA 23505-3845
(757) 664-6670
(757) 664-6676
Mailing address
321 WOODS EDGE CT, VIRGINIA BEACH, VA 23462-4358
(757) 275-3739
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701010857
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0701010857
BOARD OF COUNSELING
VA
Enumeration date
10/16/2021
Last updated
10/16/2021
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