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General NPI Number Information
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NPI Number | 1295505055
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Entity Type | Individual
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Provider Name | SHARYL LYNN MARTIN
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Gender | Female
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Dates
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Enumeration Date | 01/03/2024
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 301 S CRAPO ST
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858-2941
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Country | US
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Telephone | 989-506-8437
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Fax |
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Provider Business Mailing Address
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Address Line | 1529 E GAYLORD ST UNIT C
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City | MOUNT PLEASANT
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State | MI
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Zip | 48858-6609
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Country | US
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Telephone | 989-400-8465
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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