Basic Information
| Provider Information | |||||||||
| NPI: | 1639428402 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARTS | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | OCTAVIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3201 RUE PARC FONTAINE | ||||||||
| Address2: | APT 2723 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701316960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042489021 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2626 CHARLES DR | ||||||||
| Address2: | STE. 211 | ||||||||
| City: | CHALMETTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700433779 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5042784006 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2012 | ||||||||
| LastUpdateDate: | 09/07/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.