| NPI | 1629421904 |
|---|---|
| Other Name | CHARLIE MARTIN |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 1140184) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2026-03-17 |