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Diane Watson Martin, LCSW
Mental Health Counselor in Chubbuck, Idaho
NPI 1265678387

Diane Watson Martin is a Mental Health Counselor based in Chubbuck, ID and is specialized in Mental Health. Diane Watson Martin practices in Chubbuck, ID and has the professional credentials of LCSW. The NPI Number for Diane Watson Martin is 1265678387 and holds a License No. LCSW726 (Idaho).

The current practice location address for Diane Watson Martin is 4460 Central Way, Chubbuck, ID and can be reached out via phone at 208-237-1711 and via fax at 208-237-5192.

Location: 4460 Central Way, Chubbuck, ID, 83202-5095
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265678387
Provider Name
Diane Watson Martin
Credential
LCSW
Provider Entity Type
Individual
Gender
Female
Address
4460 Central Way, Chubbuck, ID, 83202-5095
Phone Number
208-237-1711
Fax Number
208-237-5192
Provider Enumeration Date
12/18/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
807197600 05 ID
institution
Provider Business Practice Location Address Details
Address
4460 Central Way
City
Chubbuck
State
Idaho
Zip
83202-5095
Phone Number
208-237-1711
Fax Number
208-237-5192
person
Provider Business Mailing Address Details
Address
4460 Central Way
City
Chubbuck
State
Idaho
Zip
83202-5095
Phone Number
208-237-1711
Fax Number
208-237-5192
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
LCSW726 (Idaho)
Definition
Definition to come...
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