Individual
MS. GLORIA ANN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
325 IL ROUTE 2, DIXON, IL 61021-9118
(815) 284-6611
Mailing address
212 CRAWFORD AVE, DIXON, IL 61021-3136
(815) 288-4081
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
IL
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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