Individual
MARTHA MABONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5810 SHELBY OAKS DR, MEMPHIS, TN 38134-7315
(901) 648-9354
Mailing address
5810 SHELBY OAKS DR, MEMPHIS, TN 38134-7315
(901) 648-9354
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YS0200X
School Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
103TF0000X
Family Psychologist
—
—
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87433703
—
TN
Enumeration date
02/04/2022
Last updated
02/04/2022
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