Individual
TRACY L MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
108 ENSMINGER DR STE A, GLASGOW, KY 42141-1157
(270) 659-0035
(270) 629-4880
Mailing address
PO BOX 1205, MORGANTOWN, KY 42261-1205
(270) 791-5528
(270) 526-2218
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
254543
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851937908
—
KY
Enumeration date
11/25/2019
Last updated
09/29/2021
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