Martin, Eva Diane

Martin, Eva Diane is an sole proprietor health care provider with primary practice located at 2920 Marietta Highway Suite 146, Canton GA 30114. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Martin, Eva Diane can be contacted via phone (470) 253-7252.

Contact Information

Primary practice address
2920 Marietta Highway Suite 146 Canton GA 30114
Phone: (470) 253-7252
Fax: (800) 397-1710
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC001690 Georgia
Behavioral Health & Social Service Providers / School 101YS0200X LPC001690 Georgia
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X LPC001690 Georgia

Profile Details

NPI number 1326342098
LBN Legal business name Martin, Eva Diane
Credentials MS, LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 10th, 2011
Last updated Jan 26th, 2015 - about 9 years 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 1326342098 NPPES
Georgia MEDICAID 003106189B

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