Individual
LORI SUZANNE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC II, NCAC II
Contact information
Practice address
810 MULBERRY ST, LOUDON, TN 37774-1309
(865) 657-9303
Mailing address
2405 CALDERWOOD HWY, MARYVILLE, TN 37801-0823
(865) 776-4354
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LDC0000000672
TN
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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