Individual
ELIZABETH BROOKE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2148 W CHESTERFIELD BLVD STE E205, SPRINGFIELD, MO 65807-8650
(417) 812-6850
(417) 812-6858
Mailing address
2148 W CHESTERFIELD BLVD STE E205, SPRINGFIELD, MO 65807-8650
(417) 655-5847
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2016035397
MO
1041C0700X
Clinical Social Worker
Primary
2020005419
MO
Other
Enumeration date
01/10/2017
Last updated
03/03/2023
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