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General NPI Number Information
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NPI Number | 1447795588
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Entity Type | Individual
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Provider Name | KRISTINA MARTIN LPCC
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Gender | Female
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Dates
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Enumeration Date | 12/28/2016
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Last Update Date | 10/29/2021
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Provider Practice Location Address
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Address Line | 15300 PEARL RD
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City | STRONGSVILLE
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State | OH
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Zip | 44136-5091
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Country | US
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Telephone | 216-536-6248
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Fax |
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Provider Business Mailing Address
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Address Line | 4430 SIR RICHARD AVE
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City | NORTH ROYALTON
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State | OH
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Zip | 44133-4135
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Country | US
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Telephone | 162-536-6248
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.1700093
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License Number State | OH
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