Provider Information for 1003467267
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MARTRELL DENISE KELLY JOHN LISW-CP
Sex: Female
NPI: 1003467267
Last Updated: 2019-09-27
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1003467267 | ||||||||||||
| Enumeration Date | 2019-09-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 139 HARMONY DR SPARTANBURG, SC 29301-5729 United States Phone: 240-463-7794 | Fax: | ||||||||||||
| Primary Practice Address | 250 COMMONWEALTH DR GREENVILLE, SC 29615-4846 United States Phone: 240-463-7794 | Fax: | ||||||||||||
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