Doctor Name: | DR. JANET STILLMAN MARTIN |
NPI Number: | 1215181128 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 1134 |
Business Practice Address: | 1551 Jennings Mill Rd Bogart, GA - 306222552 |
Business Phone Number: | 7063389551 |
Business Fax Number: | 7065493596 |
Mailing Address: | 1551 Jennings Mill Rd, BOGART |
State: | GA |
Postal Code: | 306222552 |
Phone Number: | 7063389551 |
Fax Number: | 7065493596 |
NPI Enumeration Date: | 11/06/2008 |
NPI Last Update Date: | 11/06/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 1134 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |