Individual
ANGELA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
235 WHITESTICK ST, MABSCOTT, WV 25871
(304) 731-0925
Mailing address
PO BOX 628, MABSCOTT, WV 25871-0628
(304) 731-0925
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
CP00941029
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP00941029
SOCIAL WORK LICENSE
WV
Enumeration date
09/06/2018
Last updated
09/06/2018
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