Individual
LISA E MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
520 SUPERIOR ST, PORT HURON, MI 48060-3838
(810) 984-4202
Mailing address
520 SUPERIOR ST, PORT HURON, MI 48060-3838
(810) 984-4202
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6801083307
MI
Other
Enumeration date
08/16/2006
Last updated
02/19/2009
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