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General NPI Number Information
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NPI Number | 1417057076
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Entity Type | Individual
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Provider Name | ALMA LYNNE MARTIN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 609 E LUDINGTON AVE
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City | LUDINGTON
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State | MI
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Zip | 49431-2264
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Country | US
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Telephone | 231-843-8849
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Fax |
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Provider Business Mailing Address
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Address Line | 8723 96TH AVE
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City | PENTWATER
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State | MI
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Zip | 49449-8505
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Country | US
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Telephone | 231-869-5861
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6301009150
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License Number State | MI
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