Provider Demographics
NPI:1265761928
Name:MARTIN, JODIE MARIE (MGC, CGC)
Entity type:Individual
Prefix:
First Name:JODIE
Middle Name:MARIE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MGC, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MICHIGAN AVE NW
Mailing Address - Street 2:DEPARTMENT OF NEUROLOGY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2916
Mailing Address - Country:US
Mailing Address - Phone:202-476-6249
Mailing Address - Fax:202-476-5226
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-6249
Practice Address - Fax:202-476-5226
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS