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NPI 1366085128

NPI 1366085128 : MARTIN WINFIELD GARMAN LAC : TEMPE, AZ

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General NPI Number Information
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    NPI Number           |    1366085128
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    Entity Type          |    Individual 
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    Provider Name        |    MARTIN WINFIELD GARMAN LAC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/24/2019
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    Last Update Date     |    10/24/2019
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Provider Practice Location Address
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    Address Line         |    2120 S MCCLINTOCK DR STE 105 
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    City                 |    TEMPE
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    State                |    AZ
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    Zip                  |    85282-2692
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    Country              |    US
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    Telephone            |    480-804-0326
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1400 E SOUTHERN AVE STE 735 
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    City                 |    TEMPE
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    State                |    AZ
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    Zip                  |    85282-5699
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    Country              |    US
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    Telephone            |    480-804-0326
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    Fax                  |    480-804-0083
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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        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    
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    License Number State |    
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