Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | OT000603 | OH |
NPI | 1588808885 |
---|---|
Provider Name | Linda K Martin |
First Address | Dayton, OH 45417-3424 |
Second Address | Dayton, OH 45417-3424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2009 |
Last Update Date | 13/05/2020 |