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General NPI Number Information
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NPI Number | 1245244714
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Entity Type | Individual
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Provider Name | LINDA E MARTIN PHD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 630 BREVARD AVE STE 100
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City | COCA
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State | FL
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Zip | 32922
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Country | US
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Telephone | 321-433-1466
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Fax | 321-433-1467
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Provider Business Mailing Address
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Address Line | 240 NERA AVE
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City | MERRITT ISLAND
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State | FL
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Zip | 32952
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Country | US
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Telephone | 321-433-1466
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Fax | 321-433-1467
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY3875
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT1001
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License Number State | FL
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