Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP1600X | Pastoral Counselor | AZ | |
N | 101YP1600X | Pastoral Counselor | P0214763 | AZ |
N | 103K00000X | Behavior Analyst | ||
N | 103K00000X | Behavior Analyst | AZ | |
N | 175L00000X | Homeopath | 00012 | ZZ |
NPI | 1912230178 |
---|---|
Provider Name | Ms. Mozelle Barr Martin |
First Address | Safford, AZ 85546 |
Second Address | Phoenix, AZ 85051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2009 |
Last Update Date | 25/09/2020 |