Individual
MARY WALLACE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2814 GRAY FOX RD, MONROE, NC 28110-8422
(704) 821-0568
Mailing address
1 SHADY LN, GREENVILLE, SC 29605-1260
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
18157
NC
225X00000X
Occupational Therapist
7820
SC
Other
Enumeration date
12/29/2025
Last updated
12/29/2025
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