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NPI Code Detail

MEDICARE: VICKY LYNN MARTIN PLPC

MEDICARE: VICKY LYNN MARTIN PLPC
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
1101YP2500XProfessional Counselor2017019597MO

General Provider Information

NPI Number : 1508375585
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKY LYNN MARTIN PLPC
Provider Business Mailing Address
First Line : 1513 UNION AVE STE 2500
Second Line :
City : MOBERLY
State : MO
Zip : 65270-9412
Country : US
Telephone Number : 660-372-1313
Fax Number :
Provider Business Practice Location Address
First Line : 1513 UNION AVE STE 2500
Second Line :
City : MOBERLY
State : MO
Zip : 65270-9412
Country : US
Telephone Number : 660-372-1313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2017
Last Update Date : 01/05/2024

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Directions to “ VICKY LYNN MARTIN PLPC” Practice Location

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