Provider Demographics
NPI:1376172734
Name:MARTIN, YOHIRIS
Entity Type:Individual
Prefix:
First Name:YOHIRIS
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:YOHIRIS
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FAMILY THERAPIST
Mailing Address - Street 1:1027 REGENCY DR
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-1364
Mailing Address - Country:US
Mailing Address - Phone:404-946-2511
Mailing Address - Fax:404-738-7385
Practice Address - Street 1:1027 REGENCY DR
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-1364
Practice Address - Country:US
Practice Address - Phone:404-946-2511
Practice Address - Fax:404-738-7385
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00143475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health