Individual
MR. RICHARD LEEDS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1396 OLD MILL CIRCLE, SOTILE PSYCHOLOGICAL ASSOCIATES, PLLC, WINSTON-SALEM, NC 27103
(336) 765-3032
(336) 760-6977
Mailing address
5405 AUBREY CT, PFAFFTOWN, NC 27040-9384
(336) 765-3032
(336) 760-6977
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC748
NC
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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