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General NPI Number Information
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NPI Number | 1184146235
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Entity Type | Individual
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Provider Name | INGRID MARTIN
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Gender | Female
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Dates
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Enumeration Date | 07/11/2017
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 119 N MAIN ST
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City | WEATHERFORD
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State | TX
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Zip | 76086-3257
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Country | US
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Telephone | 954-907-0803
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Fax |
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Provider Business Mailing Address
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Address Line | 815 FERGUSON RD
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City | MINERAL WELLS
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State | TX
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Zip | 76067-8290
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Country | US
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Telephone | 954-907-0803
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 81477
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH16224
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License Number State | FL
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