Doctor Name: | KRYSTAL L MARTIN |
NPI Number: | 1144512310 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW |
License Number: | I.1000293 |
Business Practice Address: | 338 Granville St Gahanna, OH - 432302990 |
Business Phone Number: | 6144757090 |
Business Fax Number: | 6144755208 |
Mailing Address: | 338 Granville St, GAHANNA |
State: | OH |
Postal Code: | 432302990 |
Phone Number: | 6144757090 |
Fax Number: | 6144755208 |
NPI Enumeration Date: | 05/06/2011 |
NPI Last Update Date: | 05/06/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I.1000293 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |