Martin, Angela Maria

Martin, Angela Maria is an individual health care provider with primary practice located at 12225 71St St , Kenosha WI 53142-7320. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Martin, Angela Maria can be contacted via phone (877) 666-7223.

Contact Information

Primary practice address
12225 71St St Kenosha WI 53142-7320
Phone: (877) 666-7223
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 6568 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 6568-123 Wisconsin

Profile Details

NPI number 1417018664
LBN Legal business name Martin, Angela Maria
Credentials MSW, LCSW
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Feb 21st, 2024 - about 9 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417018664 NPPES
Wisconsin MEDICAID 39746200

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