Doctor Name: | MS. DEBORAH JEAN MARTIN |
NPI Number: | 1144416884 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | 2095125 |
Business Practice Address: | 227 5th Ave Baraboo, WI - 539132116 |
Business Phone Number: | 6083569066 |
Business Fax Number: | |
Mailing Address: | 227 5th Ave, BARABOO |
State: | WI |
Postal Code: | 539132116 |
Phone Number: | 6083569066 |
Fax Number: | |
NPI Enumeration Date: | 09/17/2007 |
NPI Last Update Date: | 09/17/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2095125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |