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General NPI Number Information
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NPI Number | 1548916067
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Entity Type | Individual
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Provider Name | BRITTANY ELIZABETH MARTYR LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 709 S 5TH ST
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City | FORT PIERCE
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State | FL
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Zip | 34950-8339
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Country | US
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Telephone | 772-467-3097
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Fax | 855-708-4622
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Provider Business Mailing Address
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Address Line | 4238 SE GRAHAM DR
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City | STUART
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State | FL
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Zip | 34997-1541
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Country | US
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Telephone | 772-485-4246
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 19364
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License Number State | FL
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