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Individual

CAROLYN RAE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC

Contact information

Practice address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 656-7009
Mailing address
1406 6TH AVE N, SAINT CLOUD, MN 56303-1900
(320) 251-2700
(320) 656-7009

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300544
MN

Other

Enumeration date
02/12/2018
Last updated
02/12/2018
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