| Doctor Name: | MRS. LAURA MARTIN |
| NPI Number: | 1235583097 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | 5961 |
| Business Practice Address: | 110 Ye Olde Kings Hwy North Myrtle Beach, SC - 295824384 |
| Business Phone Number: | 8436630770 |
| Business Fax Number: | |
| Mailing Address: | 281 Sugar Mill Loop, MYRTLE BEACH |
| State: | SC |
| Postal Code: | 295884631 |
| Phone Number: | 8434469217 |
| Fax Number: | |
| NPI Enumeration Date: | 04/19/2016 |
| NPI Last Update Date: | 04/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 5961 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |