Individual provider · Type 1 NPI

Mark Randall Martin, L.C.P.C.

Professional Counselor · Bloomington, IL

NPI number 1467563205 Active

Practice location

1505 Eastland Dr, Emp II Ll 1000
Bloomington, IL 61701-3534

Call (309) 663-1623 Map

Mailing address

45 Brookshire Grn
Bloomington, IL 61704-6211

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XNone listed

Professional Counselor: Definition to come...

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About NPI 1467563205

Mark Randall Martin, L.C.P.C.'s National Provider Identifier is 1467563205, issued on Aug 31, 2006. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Bloomington, IL. The record was last updated on Jul 8, 2007.