Individual
RICHARD WAYNE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LMFT,LPC,CADC
Contact information
Practice address
22 NORTH PELHAM ST. BOX 622, RHINELANDER, WI 54501-0622
(715) 365-6696
(715) 365-6768
Mailing address
6460 LOGGING CAMP RD, RHINELANDER, WI 54501-8102
(715) 282-8655
(715) 365-6768
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4249-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39209400
—
WI
Enumeration date
06/22/2006
Last updated
07/08/2007
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