Provider Demographics
NPI:1700164845
Name:VANN, MARTA JEANETTE (MS LPC CANDIDATE)
Entity Type:Individual
Prefix:MRS
First Name:MARTA
Middle Name:JEANETTE
Last Name:VANN
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Gender:F
Credentials:MS LPC CANDIDATE
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Mailing Address - Street 1:1910 SOUTH MUSKOGEE STREET
Mailing Address - Street 2:HARTSELL PSYCHOLOGICAL SERVICES
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464
Mailing Address - Country:US
Mailing Address - Phone:918-458-5757
Mailing Address - Fax:918-458-5755
Practice Address - Street 1:1910 SOUTH MUSKOGEE STREET
Practice Address - Street 2:HARTSELL PSYCHOLOGICAL SERVICES
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464
Practice Address - Country:US
Practice Address - Phone:918-458-5757
Practice Address - Fax:918-458-5755
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health