Provider Demographics
NPI:1336454974
Name:MARTIN, PEGGY L (LPC)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:L
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 COUNTY ROAD 90 STE 119
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4891
Mailing Address - Country:US
Mailing Address - Phone:281-485-9280
Mailing Address - Fax:281-485-9070
Practice Address - Street 1:2225 COUNTY ROAD 90 STE 119
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4891
Practice Address - Country:US
Practice Address - Phone:281-485-9280
Practice Address - Fax:281-485-9070
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64842101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor