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General NPI Number Information
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NPI Number | 1902700347
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Entity Type | Individual
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Provider Name | MADELYNN MARTIN LAC
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Gender | Female
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 7287 E EARLL DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7230
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Country | US
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Telephone | 480-418-1570
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Fax | 480-956-0806
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Provider Business Mailing Address
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Address Line | 5225 E THOMAS RD APT 137
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City | PHOENIX
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State | AZ
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Zip | 85018-8005
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Country | US
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Telephone | 602-469-9169
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LAC-24254
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License Number State | AZ
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