MEDICARE: LORIANA A MARTIN LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	72118	TX

General Provider Information

NPI Number	:	1306350848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORIANA A MARTIN LPC

Provider Business Mailing Address
First Line	:	20519 TREE MDW
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3165
Country	:	US
Telephone Number	:	787-358-3802
Fax Number	:

Provider Business Practice Location Address
First Line	:	641 N WALNUT AVE
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-7925
Country	:	US
Telephone Number	:	830-730-6090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2017
Last Update Date	:	11/20/2017

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Directions to “ LORIANA A MARTIN LPC” Practice Location

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