Individual
MICHELE MARION MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
636 CHURCH ST, SUITE 601, EVANSTON, IL 60201-4508
(847) 624-2776
Mailing address
537 SHERIDAN RD, APT. 2 SOUTH, EVANSTON, IL 60202-3193
(847) 733-0319
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166000697
IL
Other
Enumeration date
06/12/2007
Last updated
07/08/2007
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