Provider Demographics
NPI:1558919035
Name:VALLIN, MARTHA (MS, MED, LPC-A)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:VALLIN
Suffix:
Gender:F
Credentials:MS, MED, LPC-A
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:
Other - Last Name:PEGUERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12803 FOLKGLEN CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-3871
Mailing Address - Country:US
Mailing Address - Phone:832-512-9468
Mailing Address - Fax:
Practice Address - Street 1:1560 W BAY AREA BLVD STE 303
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-2681
Practice Address - Country:US
Practice Address - Phone:832-224-9143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97507101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional