Provider Demographics
NPI:1407182355
Name:STRACHAN, MARTHA KIRKLAND (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:KIRKLAND
Last Name:STRACHAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 BUCKSLEY LN UNIT 209
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8178
Mailing Address - Country:US
Mailing Address - Phone:302-547-1640
Mailing Address - Fax:
Practice Address - Street 1:100 DOUGHTY STREET BA209
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-0001
Practice Address - Country:US
Practice Address - Phone:302-547-1640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5555555103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist