Provider Information for 1730421058
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Ms. JENNIFER H. MARTIN MA LPC
Other Names:Former Name:Ms. JENNIFER H. STREETER MA LPCCSex: Female
NPI: 1730421058
Last Updated: 2014-10-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1730421058 | ||||||||
| Enumeration Date | 2013-03-25 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4811 S 76TH ST SUITE 401 GREENFIELD, WI 53220-4364 United States Phone: 414-325-7741 | Fax:414-325-7753 | ||||||||
| Primary Practice Address | 4811 S 76TH ST SUITE 401 GREENFIELD, WI 53220-4364 United States Phone: 414-325-7741 | Fax:414-325-7753 | ||||||||
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