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Individual

MRS. MARY CATHERINE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA,MS, LPC

Contact information

Practice address
3550 NATIONAL DRIVE, MEDFORD, OR 97504
(541) 941-9246
Mailing address
PO BOX 503010, WHITE CITY, OR 97503-0813
(541) 941-7792
(503) 419-4662

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC1361
OR
106H00000X
Marriage & Family Therapist
Primary
LPC3061
OR

Other

Enumeration date
05/20/2007
Last updated
12/07/2017
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