| Doctor Name: | MISS SUSAN LYNN MARTIN |
| NPI Number: | 1124261102 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LPC |
| License Number: | LPC-13205 |
| Business Practice Address: | 2277 Swanson Ave. Suite B Lake Havasu City, AZ - 86403 |
| Business Phone Number: | 9288540110 |
| Business Fax Number: | 9288540112 |
| Mailing Address: | P.o. Box 1746, LAKE HAVASU CITY |
| State: | AZ |
| Postal Code: | 86405 |
| Phone Number: | 9288540110 |
| Fax Number: | 9288540112 |
| NPI Enumeration Date: | 04/07/2009 |
| NPI Last Update Date: | 10/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC-13205 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |