Provider Demographics
NPI:1841599057
Name:MARTIN, ELIZABETH D
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:D
Last Name:MARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ELIZABETH D. MARTIN, AND JAMES R. MARTIN
Mailing Address - Street 2:4610 BONITA DR
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-6835
Mailing Address - Country:US
Mailing Address - Phone:513-804-4183
Mailing Address - Fax:513-727-1532
Practice Address - Street 1:4610 BONITA DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-6835
Practice Address - Country:US
Practice Address - Phone:513-804-4183
Practice Address - Fax:513-727-1532
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)