Individual
DENINE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4437 S CICERO AVE, CHICAGO, IL 60632-4333
(773) 884-0484
Mailing address
12044 S WALLACE ST, CHICAGO, IL 60628-6324
(773) 577-3395
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056009185
IL
Other
Enumeration date
12/29/2011
Last updated
12/29/2011
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