Individual
MR. MARTIN WYNN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
411 CEDAR RD, CHESAPEAKE, VA 23322-5566
(757) 548-8848
Mailing address
411 CEDAR RD, CHESAPEAKE, VA 23322-5566
(757) 548-8848
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701001549
VA
Other
Enumeration date
09/28/2006
Last updated
07/09/2007
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