Individual
MR. JEFFREY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5804 ELAINE DR, ROCKFORD, IL 61108-2435
(815) 397-7654
(815) 397-2712
Mailing address
5804 ELAINE DR, ROCKFORD, IL 61108-2435
(815) 397-7654
(815) 397-2712
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
149003373
IL
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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