Individual
NIKKI C MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC/LADAC
Contact information
Practice address
1001 W BROADWAY # D&E, FARMINGTON, NM 87401-5638
(505) 327-4796
Mailing address
1001 W BROADWAY # D&E, FARMINGTON, NM 87401-5638
(505) 327-4796
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CTB-2022-0692
NM
101YM0800X
Mental Health Counselor
Primary
CTB-2023-0522
NM
Other
Enumeration date
06/28/2023
Last updated
06/28/2023
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