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Individual

MS. STACIA J MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
327 CHASE HILL RD, ANDOVER, NH 03216-4109
(603) 496-5214
(603) 776-0381
Mailing address
327 CHASE HILL RD, ANDOVER, NH 03216-4109
(603) 496-5214

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1336
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1065349
AETNA
NH
01
13Y008938NH01
ANTHEM BC/BS
NH
05
30413840
NH
01
386488
MVP
NH
Enumeration date
07/19/2006
Last updated
08/06/2021
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