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General NPI Number Information
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NPI Number | 1912981184
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Entity Type | Individual
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Provider Name | JUDITH B. MARTIN LMFT
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Gender | Female
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 1892 WILLAMETTE ST
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City | EUGENE
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State | OR
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Zip | 97401-4044
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Country | US
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Telephone | 541-513-9326
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Fax | 541-345-8810
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Provider Business Mailing Address
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Address Line | 1892 WILLAMETTE ST
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City | EUGENE
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State | OR
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Zip | 97401-4044
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Country | US
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Telephone | 541-513-9326
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Fax | 541-345-8810
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 000895
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T0883
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License Number State | OR
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