person
Mr. Mark Randall Martin, LCPC
Professional Counselor in Bloomington, Illinois
NPI 1467563205

Mark Randall Martin is a Professional Counselor based in Bloomington, IL and is specialized in Professional. Mark Randall Martin practices in Bloomington, IL and has the professional credentials of LCPC. The NPI Number for Mark Randall Martin is 1467563205 and holds a License No. (Illinois).

The current practice location address for Mark Randall Martin is 1505 Eastland Dr, Bloomington, IL and can be reached out via phone at 309-663-1623. You can also correspond with Mark Randall Martin through the mailing address at 45 BROOKSHIRE GRN, BLOOMINGTON, IL - 61704-6211 (mailing address contact number: 309-663-8243).

Location: 1505 Eastland Dr, Bloomington, IL, 61704-6211
person
Provider Profile Details
NPI Number
1467563205
Provider Name
Mark Randall Martin
Credential
LCPC
Provider Entity Type
Individual
Gender
Male
Address
1505 Eastland Dr, Bloomington, IL, 61704-6211
Phone Number
309-663-1623
Fax Number
Provider Enumeration Date
08/31/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1505 Eastland Dr
City
State
Zip
61701-3534
Phone Number
309-663-1623
Fax Number
person
Provider Business Mailing Address Details
Address
45 Brookshire Grn
City
State
Zip
61704-6211
Phone Number
309-663-8243
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
(Illinois)
Definition
Definition to come...
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