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General NPI Number Information
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NPI Number | 1659842953
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Entity Type | Individual
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Provider Name | LES F MARTEL PH.D
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Gender | Male
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Dates
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Enumeration Date | 12/12/2018
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 389 WHITNEY AVE
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City | NEW HAVEN
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State | CT
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Zip | 06511-2301
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Country | US
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Telephone | 203-887-6981
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Fax |
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Provider Business Mailing Address
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Address Line | 75 STONE RIDGE WAY APT 1D
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City | FAIRFIELD
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State | CT
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Zip | 06824-5381
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Country | US
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Telephone | 203-887-6981
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 001281
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License Number State | CT
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