Individual
CHRISTINE LAVELY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC/SLP
Contact information
Practice address
991 PONDELLA RD, NORTH FORT MYERS, FL 33903-3500
(352) 270-4756
Mailing address
991 PONDELLA RD, NORTH FORT MYERS, FL 33903-3500
(352) 270-4756
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA7076
FL
Other
Enumeration date
04/03/2021
Last updated
04/03/2021
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