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NPI Code Detail

MEDICARE: ASHLYN MARTINIE

MEDICARE: ASHLYN MARTINIE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1831857440
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLYN MARTINIE
Provider Business Mailing Address
First Line : 1939 DIVISION AVE S
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-2480
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1939 DIVISION AVE S
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-2480
Country : US
Telephone Number : 616-247-3815
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2021
Last Update Date : 11/30/2021

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Directions to “ ASHLYN MARTINIE ” Practice Location

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