Most Relevant Information
Provider Data
| NPI Number: | 1003211236 |
| Provider Name: | ELISABETH MARTIN |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/30/2014 |
| Last Updated: | 10/30/2014 |
Provider Practice Location
6265 SEPULVEDA BLVD
VAN NUYS
CA
914111114
Practice Location Phone/Fax
| Phone: | 8187790555 |
| Fax: |
Provider Mailing Location
6265 SEPULVEDA BLVD
VAN NUYS
CA
914111114
Provider Mailing Phone/Fax
| Phone: | 8187790555 |
| Fax: |