Individual
KILEY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2066 LAWRENCE DR, DE PERE, WI 54115-9421
(920) 338-8699
(920) 336-3181
Mailing address
2066 LAWRENCE DR, DE PERE, WI 54115-9421
(920) 338-8699
(920) 336-3181
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6835-125
WI
Other
Enumeration date
03/25/2018
Last updated
03/25/2018
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