Organization
AUDREY L. MARTIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY MARTIN (OWNER)
(316) 644-2944
Entity
Organization
Contact information
Practice address
303 N WEST ST STE 220, WICHITA, KS 67203-1269
(316) 302-4988
Mailing address
23527 SYCAMORE HEIGHTS RD, SILOAM SPRINGS, AR 72761-8215
(316) 644-2944
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200656430B
—
KS
Enumeration date
02/08/2021
Last updated
09/16/2024
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