Individual
MS. KIMBERLY ANN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
301 SICOMAC AVE, CHRISTIAN HEALTHCARE CENTER, WYCKOFF, NJ 07481
(201) 848-4323
Mailing address
118 SICOMAC AVE, MIDLAND PARK, NJ 07432-1756
(201) 444-0142
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00043600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46TR00043600
LICENSE NUMBER
NJ
Enumeration date
11/20/2012
Last updated
11/20/2012
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