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General NPI Number Information
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NPI Number | 1619848991
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Entity Type | Organization
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Legal Business Name | MEAGHAN MARTIN LICENSED CLINICIAL SOCIAL WORKER CORPORATION
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 5634 DOGWOOD RD
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City | WRIGHTWOOD
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State | CA
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Zip | 92397
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Country | US
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Telephone | 760-981-9533
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1686
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City | WRIGHTWOOD
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State | CA
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Zip | 92397-1686
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Country | US
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Telephone | 760-981-9533
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MEAGHAN MARTIN
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Credential |
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Telephone | 760-981-9533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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