Individual
KELLIANNE KRISTIAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 EAST STATE STREET, KENNETT SQUARE, PA 19348
(855) 497-6446
Mailing address
108B LINN DRIVE, VERONA, NJ 07044
(973) 857-8360
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00280000
NJ
Other
Enumeration date
08/14/2012
Last updated
08/14/2012
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