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NPI Code Detail

MEDICARE: MARTHA GRIFFIN WRENN

MEDICARE: MARTHA GRIFFIN WRENN
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
1101YM0800XMental Health CounselorA22491NC

General Provider Information

NPI Number : 1962351494
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA GRIFFIN WRENN
Provider Business Mailing Address
First Line : 5705 PARKSTONE DR
Second Line :
City : MATTHEWS
State : NC
Zip : 28104-0564
Country : US
Telephone Number : 704-989-1269
Fax Number :
Provider Business Practice Location Address
First Line : 5820 E W T HARRIS BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28215-3541
Country : US
Telephone Number : 704-269-8025
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2026
Last Update Date : 01/27/2026

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Directions to “ MARTHA GRIFFIN WRENN ” Practice Location

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