Individual
TIMOTHY M MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
925 WASH RD, FRANKFORT, KY 40601-8426
(859) 253-1686
(859) 254-2743
Mailing address
1351 NEWTOWN PIKE, LEXINGTON, KY 40511-1217
(859) 253-1686
(859) 254-2743
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0902
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30615058
—
KY
Enumeration date
03/12/2007
Last updated
07/09/2007
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