Doctor Name: | WILLIAM MICHAEL MARTYN |
NPI Number: | 1225300742 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.ED., L.A.C., N.C.C |
License Number: | 1398 |
Business Practice Address: | 1799 Stumpf Blvd Bldg 7 Terrytown, LA - 700563950 |
Business Phone Number: | 5043674426 |
Business Fax Number: | |
Mailing Address: | 1799 Stumpf Blvd Bldg 7, TERRYTOWN |
State: | LA |
Postal Code: | 700563950 |
Phone Number: | 5043674426 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2012 |
NPI Last Update Date: | 01/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1398 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |