Individual
DERRICE LAMONTE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RECOVERY COACH
Contact information
Practice address
2091 PROFESSIONAL DR, FLINT, MI 48532-3657
(810) 732-1652
Mailing address
2091 PROFESSIONAL DR, FLINT, MI 48532-3657
(810) 732-1652
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
MI
Enumeration date
07/28/2017
Last updated
02/26/2025
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