| NPI | 1114709961 |
|---|---|
| Other Name | ATHELA MARIE MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH QBHS) |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2023-10-17 |