Individual
MARTHA JAXTIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC-I
Contact information
Practice address
400 NATHAN ELLIS HWY STE B, MASHPEE, MA 02649-3121
(774) 255-0635
Mailing address
PO BOX 56, FALMOUTH, MA 02541-0056
(774) 255-0635
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
471
MA
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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