Individual
SUSAN M MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
602 E GRAND AVE, DES MOINES, IA 50309-1924
(515) 283-1230
(515) 283-2256
Mailing address
301 W BURLINGTON AVE, FAIRFIELD, IA 52556-3242
(641) 472-1684
(641) 472-4609
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
03816
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0224949
—
IA
01
—
231967
MIDLANDS
IA
01
—
33170
WELLMARK
IA
01
—
465309
VALUE OPTIONS RAILROAD
IA
Enumeration date
08/05/2006
Last updated
07/09/2007
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