Provider Information for 1114463643
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Mr. MARTIN BENTON PRICE M.S., LCPC
Sex: Male
NPI: 1114463643
Last Updated: 2019-01-17
Certification Date:
Certification Date:
Details
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NPI | 1114463643 | ||||||||
Enumeration Date | 2017-01-08 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 22 STANFORD RD HAGERSTOWN, MD 21742-4517 United States Phone: 301-660-1662 | Fax: | ||||||||
Primary Practice Address | 1459 POTOMAC AVE HAGERSTOWN, MD 21742-3315 United States Phone: 240-513-4551 | Fax:410-848-5629 | ||||||||
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