Provider Demographics
NPI:1497491401
Name:MARTAL PREWITT LLC
Entity Type:Organization
Organization Name:MARTAL PREWITT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MARRIAGE AND FAMILYTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARTAL
Authorized Official - Middle Name:LEE SPARKS
Authorized Official - Last Name:PREWITT
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:509-850-7327
Mailing Address - Street 1:8817 E MISSION AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VLY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-5034
Mailing Address - Country:US
Mailing Address - Phone:509-850-7327
Mailing Address - Fax:
Practice Address - Street 1:8817 E MISSION AVE STE 106
Practice Address - Street 2:
Practice Address - City:SPOKANE VLY
Practice Address - State:WA
Practice Address - Zip Code:99212-5034
Practice Address - Country:US
Practice Address - Phone:509-850-7327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health