Provider Demographics
NPI:1912634809
Name:MARTIN, ANGELA GRIGGS (LMFT-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:GRIGGS
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 LYTLE SHORES DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-5206
Mailing Address - Country:US
Mailing Address - Phone:325-829-2849
Mailing Address - Fax:
Practice Address - Street 1:542 HICKORY ST STE 202
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5002
Practice Address - Country:US
Practice Address - Phone:325-829-2849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204674106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist