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General NPI Number Information
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NPI Number | 1609439009
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Entity Type | Individual
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Provider Name | EMILY ANNE MARTIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/21/2019
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 2701 17TH ST
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City | ROCK ISLAND
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State | IL
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Zip | 61201-5351
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Country | US
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Telephone | 701-202-9043
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Fax |
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Provider Business Mailing Address
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Address Line | 1027 16TH ST
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City | ROCK ISLAND
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State | IL
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Zip | 61201-2556
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Country | US
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Telephone | 701-202-9043
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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 | 089759
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149027984
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License Number State | IL
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