Individual provider · Type 1 NPI
Jessica Alyssa Martin
Mental Health Counselor · Dallas, PA
NPI number
1629349600
Active
Practice location
1172 Twin Stacks Dr # 427
Dallas, PA 18612-8505
Fax (570) 674-8679
Mailing address
260 Watkins St
Swoyersville, PA 18704-2139
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1629349600
Jessica Alyssa Martin's National Provider Identifier is 1629349600, issued on Jan 23, 2012. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Dallas, PA. The record was last updated on Jan 23, 2012.