Individual
CARLYE J MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2865 E MAIN ST, HUMBOLDT, TN 38343-3070
(731) 784-8405
Mailing address
516 VERANO ST, MEDINA, TN 38355-6921
(901) 413-7578
(855) 232-8604
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3190
TN
Other
Enumeration date
02/26/2019
Last updated
08/12/2020
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