Individual
BRENDA J. MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CCA
Contact information
Practice address
7476 S BROADWAY, RED HOOK, NY 12571-1772
(845) 702-2066
Mailing address
1414 ROUTE 82, ANCRAM, NY 12502-5120
(845) 702-2066
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
016543-1
NY
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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