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Individual
TARA MARIE MARTELLO
Active
Individual
TARA MARIE MARTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTRL
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT21580
FL
225XP0200X
Pediatric Occupational Therapist
46TR00316400
NJ
225XP0200X
Pediatric Occupational Therapist
OC008357
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109803400
—
FL
Enumeration date
05/28/2007
Last updated
06/03/2021
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