Amanda Beth Martin
Professional Counselor
E7475 Rawhide Rd
New London
, Wisconsin 54961-9025
Amanda Beth Martin
Professional Counselor
E7475 Rawhide Rd
New London
, Wisconsin 54961-9025
(920) 531-2686
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About
Features
Specialties
- Professional Counselor
Languages spoken
- English
Location
First Address
- Amanda Beth Martin
- E7475 Rawhide Rd
- New London, WI
- Zip : 54961-9025
- Fax : (920) 531-2686
- Phone : (877) 300-9101
Second Address
- Amanda Beth Martin
- E7475 Rawhide Rd
- New London, WI
- Zip : 54961-9025
- Phone : (877) 300-9101
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YP2500X | Professional Counselor | 3551-226 | WI |
National Provider Identifier
| NPI | 1003388380 |
|---|---|
| Provider Name | Amanda Beth Martin |
| First Address | New London, WI 54961-9025 |
| Second Address | New London, WI 54961-9025 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/12/2018 |
| Last Update Date | 26/12/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.