Individual
JESSICA MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
390 N SPRING RD, WESTERVILLE, OH 43082-1888
(614) 797-6633
(614) 797-6601
Mailing address
899 E BROAD ST FL 3, COLUMBUS, OH 43205-1156
(614) 355-8000
(614) 355-8018
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S0700385
OH
1041C0700X
Clinical Social Worker
Primary
I.0900208-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08258
—
OH
Enumeration date
10/09/2008
Last updated
08/12/2019
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