Individual
ANDREA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
603 N WAYNE ST, ANGOLA, IN 46703-1081
(260) 668-8797
(260) 665-1620
Mailing address
PO BOX 98, ANGOLA, IN 46703-0098
(260) 668-8797
(260) 665-1620
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401010001
MI
Other
Enumeration date
11/15/2020
Last updated
11/15/2020
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