Individual
MARTHA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1021
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
850441031
—
NM
Enumeration date
05/02/2011
Last updated
12/17/2013
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