Healthcare Provider Details

I. General information

NPI: 1962710392
Provider Name (Legal Business Name): LAURA M MARTIN MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 W CHOCOLATE AVE
HERSHEY PA
17033-1632
US

IV. Provider business mailing address

513 W CHOCOLATE AVE
HERSHEY PA
17033-1632
US

V. Phone/Fax

Practice location:
  • Phone: 717-298-0708
  • Fax:
Mailing address:
  • Phone: 717-298-0708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: