| NPI | 1467580688 |
|---|---|
| Former Name | HEATHER LYNN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AL 3661C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AL 1564C) |
| 1041C0700X Social Worker, Clinical (Licence: TN 3363) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2021-02-24 |