| Doctor Name: | MR. GREGORY JOHN MARTIN |
| NPI Number: | 1053509059 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC, NCC |
| License Number: | |
| Business Practice Address: | 64 Susie Wilson Rd Essex Junction, VT - 054522808 |
| Business Phone Number: | 8023633220 |
| Business Fax Number: | |
| Mailing Address: | 64 Susie Wilson Rd, ESSEX JUNCTION |
| State: | VT |
| Postal Code: | 054522808 |
| Phone Number: | 8023633220 |
| Fax Number: | |
| NPI Enumeration Date: | 10/04/2007 |
| NPI Last Update Date: | 10/15/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |