Individual provider · Type 1 NPI
Paula Shane Martin, MS, LSW, LMHC
Mental Health Counselor · Fort Wayne, IN
NPI number
1649480625
Active
Practice location
909 E State Blvd
Fort Wayne, IN 46807-3513
Mailing address
909 E State Blvd
Fort Wayne, IN 46805-3404
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 39001302A (IN) |
Mental Health Counselor: Definition to come...
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About NPI 1649480625
Paula Shane Martin, MS, LSW, LMHC's National Provider Identifier is 1649480625, issued on May 22, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fort Wayne, IN. The record was last updated on Nov 23, 2009.