Individual
JESSICA LEIGH MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
603 N MAIN ST, MOUNT VERNON, MO 65712-1074
(417) 466-7844
(417) 466-2625
Mailing address
PO BOX 568, MOUNT VERNON, MO 65712-0568
(417) 466-7844
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2016034444
MO
Other
Enumeration date
01/30/2018
Last updated
01/30/2018
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