Most Relevant Information
Provider Data
| NPI Number: | 1003027046 |
| Provider Name: | KEITH STANLEY MARTIN LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | LCS 15670 |
Most Important Dates
| Enumeration Date: | 05/24/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
9300 VALLEY CHILDRENS PL
MADERA
CA
936388761
Practice Location Phone/Fax
| Phone: | 5583533000 |
| Fax: | 5593535838 |
Provider Mailing Location
4507 W. BERKELEY AVENUE
FRESNO
CA
93722
Provider Mailing Phone/Fax
| Phone: | 5592761251 |
| Fax: |