Doctor Name: | DR. DAVID EMIL MARTINSON |
NPI Number: | 1184839409 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | PC006495 |
Business Practice Address: | 490 Lancaster Ave #15 Box 761 Frazer, PA - 193550907 |
Business Phone Number: | 8644307980 |
Business Fax Number: | |
Mailing Address: | Po Box 761, FRAZER |
State: | PA |
Postal Code: | 193550907 |
Phone Number: | 8644307980 |
Fax Number: | |
NPI Enumeration Date: | 05/11/2007 |
NPI Last Update Date: | 10/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC006495 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |