Provider Demographics
NPI:1114264546
Name:MARTIN, RONNETTE ELIZABETH (DR)
Entity Type:Individual
Prefix:MISS
First Name:RONNETTE
Middle Name:ELIZABETH
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15402
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17105-5402
Mailing Address - Country:US
Mailing Address - Phone:717-592-1031
Mailing Address - Fax:717-238-8732
Practice Address - Street 1:245 SENECA ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-1876
Practice Address - Country:US
Practice Address - Phone:717-592-1031
Practice Address - Fax:717-238-8732
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral