MR. Mark Randall Martin, L.C.P.C.
NPI #1467563205 in Bloomington, Illinois
Provider Information
- NPI Number
- 1467563205
- Entity Type
- Individual
- Name
- MR. Mark Randall Martin, L.C.P.C.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Professional
- Credential
- L.C.P.C.
- Enumeration Date
- Aug 31, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1505 EASTLAND DR
- Address 2
- EMP II LL 1000
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61701-3534
- Phone
- (309) 663-1623
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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