Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 2157-120 | WI |
N | 104100000X | Social Worker | 697 | ND |
Y | 104100000X | Social Worker | 8966 | MN |
NPI | 1003188434 |
---|---|
Provider Name | Ms. Catherine Colette Martin |
First Address | Ellsworth, WI 54011-9230 |
Second Address | Ellsworth, WI 54011-9230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2012 |
Last Update Date | 01/02/2012 |