Individual
KATHERINE THELMA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
722 S 10TH ST, PHILADELPHIA, PA 19147-1916
(215) 990-7937
Mailing address
722 S 10TH ST, PHILADELPHIA, PA 19147-1916
(215) 990-7937
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PS006214L
PA
103TB0200X
Cognitive & Behavioral Psychologist
PS006214L
PA
103TC0700X
Clinical Psychologist
Primary
PS006214L
PA
103TC2200X
Clinical Child & Adolescent Psychologist
PS006214L
PA
103TF0000X
Family Psychologist
PS006214L
PA
Other
Enumeration date
01/26/2024
Last updated
01/26/2024
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