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Individual

MRS. JUDITH POWELL MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
3601 IDAHO AVE NW, WASHINGTON, DC 20016-3121
(202) 277-1102
Mailing address
3601 IDAHO AVE NW, WASHINGTON, DC 20016-3121
(202) 277-1102

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC302966
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H191
BLUE CROSSBLUE SHIELD
DC
Enumeration date
03/01/2007
Last updated
07/08/2007
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