NPI 1174305007

Erica Nicole Martin

Practitioner Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Jackson, TN

Practice location

Address: 364 N Parkway STE 8, Jackson, TN 38305-2874
Phone: (731) 431-7241
Fax: (731) 736-1111

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence I000000022582 (TN)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Tennessee →

Registry record

NPI: 1174305007
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Oct 2023
Record last updated: 6 May 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.