Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1013433101 |
---|---|
Provider Name | Mrs. Jennifer Lynn Martin |
First Address | Harrisonburg, VA 22802-2507 |
Second Address | Harrisonburg, VA 22802-2507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2017 |
Last Update Date | 21/08/2017 |