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NPI Code Detail

MEDICARE: YSAHAI HONOR-MARIE MARTIN MA, CCC-SLP

MEDICARE: YSAHAI HONOR-MARIE MARTIN MA, CCC-SLP
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
1235Z00000XSpeech-Language Pathologist12111669MI

General Provider Information

NPI Number : 1790410199
Entity Type Code : Individual
Provider Name (Legal Business Name) : YSAHAI HONOR-MARIE MARTIN MA, CCC-SLP
Provider Business Mailing Address
First Line : 3434 CHENE ST UNIT 7184
Second Line :
City : DETROIT
State : MI
Zip : 48207-7708
Country : US
Telephone Number : 313-320-4133
Fax Number :
Provider Business Practice Location Address
First Line : 9500 GRAND RIVER AVE
Second Line :
City : DETROIT
State : MI
Zip : 48204-2132
Country : US
Telephone Number : 313-491-7920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2022
Last Update Date : 07/19/2022

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