Womack, Martha B

Womack, Martha B is an sole proprietor health care provider with primary practice located at 1536 N Jefferson St Jacksonville Outpatient Clinic, Jacksonville FL 32209-6525. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Womack, Martha B can be contacted via phone (912) 447-5660.

Contact Information

Primary practice address
1536 N Jefferson St Jacksonville Outpatient Clinic Jacksonville FL 32209-6525
Phone: (912) 447-5660
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1624 Georgia

Profile Details

NPI number 1033185475
LBN Legal business name Womack, Martha B
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 26th, 2006
Last updated May 19th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033185475 NPPES
Georgia MEDICAID 000841574A

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