Individual
MARTINA BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8090 WALNUT RUN RD, CORDOVA, TN 38018-6362
(731) 697-0030
Mailing address
1069 SHAW PL, MEMPHIS, TN 38126-6307
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
25-464990
TN
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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