Provider Demographics
NPI:1669624623
Name:MARTIN, ARLENE R (EDD)
Entity type:Individual
Prefix:MS
First Name:ARLENE
Middle Name:R
Last Name:MARTIN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 HILL ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3542
Mailing Address - Country:US
Mailing Address - Phone:608-232-0210
Mailing Address - Fax:608-232-0599
Practice Address - Street 1:715 HILL ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3542
Practice Address - Country:US
Practice Address - Phone:608-232-0210
Practice Address - Fax:608-232-0599
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst