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Individual

WAYNE FREDERICK MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
7400 MERTON MINTER ST, PSYCHOLOGY SERVICE, SAN ANTONIO, TX 78229-4404
(210) 884-4643
Mailing address
7400 MERTON MINTER ST, PSYCHOLOGY SERVICE, SAN ANTONIO, TX 78229-4404
(210) 884-4643

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
16799
TX
103TF0000X
Family Psychologist
16799
TX
103TH0004X
Health Psychologist
16799
TX
103TP2701X
Group Psychotherapy Psychologist
16799
TX

Other

Enumeration date
12/05/2007
Last updated
04/24/2012
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