Provider Demographics
NPI:1851793756
Name:MARTIN, ERIKA ROSE (AT)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:ROSE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W THARPE ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-5374
Mailing Address - Country:US
Mailing Address - Phone:850-561-8060
Mailing Address - Fax:850-561-1143
Practice Address - Street 1:1000 W THARPE ST
Practice Address - Street 2:SUITE 7
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-5374
Practice Address - Country:US
Practice Address - Phone:850-561-8060
Practice Address - Fax:850-561-1143
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health