| Doctor Name: | MS. LORRIE ANNE MARTIN |
| NPI Number: | 1124379904 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 068841 |
| Business Practice Address: | 5957 Us Route 20 La Fayette, NY - 130849701 |
| Business Phone Number: | 3156773152 |
| Business Fax Number: | 3156773154 |
| Mailing Address: | 5957 Us Route 20, LA FAYETTE |
| State: | NY |
| Postal Code: | 130849701 |
| Phone Number: | 3156773152 |
| Fax Number: | 3156773154 |
| NPI Enumeration Date: | 09/20/2012 |
| NPI Last Update Date: | 09/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | 068841 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |