Provider Information for 1316718760
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Mr. GILBERT T MARTIN III LPC-SA, LMFT
Sex: Male
NPI: 1316718760
Last Updated: 2024-01-15
Certification Date: 2024-01-14
Certification Date: 2024-01-14
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1316718760 | ||||||||||||
| Enumeration Date | 2024-01-15 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 101 TRACE WEST RD WEST MONROE, LA 71291-9145 United States Phone: 318-816-8427 | Fax: | ||||||||||||
| Primary Practice Address | 208 LINCOLN ST WEST MONROE, LA 71291-4510 United States Phone: 318-816-8427 | Fax: | ||||||||||||
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