Individual
REBECCA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 WHITE ST, MONROE, LA 71203-5153
(318) 537-9095
Mailing address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
200057
LA
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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