Provider Information for 1912606922
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KENDAL MARTIN LCSW
Sex: Female
NPI: 1912606922
Last Updated: 2024-05-14
Certification Date: 2024-05-14
Certification Date: 2024-05-14
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1912606922 | ||||||||
| Enumeration Date | 2023-02-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 425 BROADWAY ST PADUCAH, KY 42001-0713 United States Phone: 270-442-7121 | Fax:270-443-9692 | ||||||||
| Primary Practice Address | 425 BROADWAY ST PADUCAH, KY 42001-0713 United States Phone: 270-442-7121 | Fax: | ||||||||
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