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Organization

DEBORAH A. MARTIN, PH.D., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEBORAH A A. MARTIN-GRISSOM PH.D. (OWNER AND CEO)
(216) 647-8657
Entity
Organization

Contact information

Practice address
2460 FAIRMOUNT BLVD, SUITE 315, CLEVELAND HEIGHTS, OH 44106-3171
(216) 647-8657
Mailing address
4887 LEE RD, CLEVELAND, OH 44128-3846
(216) 647-8657

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
E007500
OH
101YM0800X
Mental Health Counselor
E007500
OH
101YP2500X
Professional Counselor
Primary
E007500
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1215265046
SOLE PROPRIETOR NPI
OH
Enumeration date
03/08/2011
Last updated
03/08/2011
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