IndividualActive
Carissa Martin, PSY D
NPI 1912373556 · Clinical Psychologist · Fulton, MO
Provider details
- NPI number
- 1912373556
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PSY D
- Sex
- Female
- Sole proprietor
- Yes
- License
- 2020004458 (MO)
Mailing address
2309 W Broadway Apt 113
Columbia, MO 65203-1274
Registry dates
- Enumerated
- 2015-08-18
- Last updated
- 2020-12-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.