Tracy Lea Martin

NPI #1053531855 in Wagoner, Oklahoma

Provider Information

NPI Number: 1053531855
Entity Type: Individual
Name: Tracy Lea Martin
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Apr 26, 2007
Last Updated: Sep 13, 2007

Practice Location

Address: 109 S HARRILL
Address 2: ERI
City: Wagoner
State: Oklahoma
ZIP Code: 74467
Phone: (918) 485-3554

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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