MEDICARE: DR. JANICE E MARTIN EDD, 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	101YP2500X	Professional Counselor	650	AL

General Provider Information

NPI Number	:	1841415940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE E MARTIN EDD, LPC

Provider Business Mailing Address
First Line	:	PO BOX 59243
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35259-9243
Country	:	US
Telephone Number	:	205-988-0805
Fax Number	:	205-978-8099

Provider Business Practice Location Address
First Line	:	1957 HOOVER CT
Second Line	:	SUITE 218
City	:	HOOVER
State	:	AL
Zip	:	35226-3622
Country	:	US
Telephone Number	:	205-988-0805
Fax Number	:

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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