Individual
MRS. TONYA MICHELLE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TVI
Contact information
Practice address
701 N 25TH ST, MIDDLESBORO, KY 40965-2112
(606) 269-8658
Mailing address
701 N 25TH ST, MIDDLESBORO, KY 40965-2112
(606) 269-8658
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1326311044
KY
252Y00000X
Early Intervention Provider Agency
—
KY
Other
Enumeration date
02/10/2012
Last updated
05/18/2016
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