| Doctor Name: | YOLANDA MARTIN |
| NPI Number: | 1184087405 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 178010274 |
| Business Practice Address: | 8311 Roosevelt Rd Forest Park, IL - 601302529 |
| Business Phone Number: | 7087717000 |
| Business Fax Number: | |
| Mailing Address: | 1170 W Erie St Apt 1307, CHICAGO |
| State: | IL |
| Postal Code: | 606425852 |
| Phone Number: | 7737102862 |
| Fax Number: | |
| NPI Enumeration Date: | 04/04/2016 |
| NPI Last Update Date: | 04/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 178010274 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |