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General NPI Number Information
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NPI Number | 1255671897
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Entity Type | Individual
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Provider Name | DENA MARTIN
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Gender | Female
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Dates
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Enumeration Date | 02/19/2013
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 8850 CICERO DR
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-2436
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Country | US
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Telephone | 561-806-9885
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Fax |
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Provider Business Mailing Address
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Address Line | 6037 WINDING LAKE DR
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City | JUPITER
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State | FL
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Zip | 33458-3777
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 005010
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH19551
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License Number State | FL
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