Individual
AMY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
500 N WASHINGTON ST STE 5, WEATHERFORD, OK 73096-5700
(580) 650-8587
Mailing address
PO BOX 985, WEATHERFORD, OK 73096-0985
(580) 650-8587
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC04518
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC04518
OKLAHOMA STATE BOARD OF BEHAVIORAL HEALTH
OK
Enumeration date
08/23/2021
Last updated
08/23/2021
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