Individual
BRETT ELLIS MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
2150 S COUNTRY CLUB DR STE 20, MESA, AZ 85210-6879
(480) 398-4280
(480) 398-4281
Mailing address
PO BOX 50218, PHOENIX, AZ 85076-0218
(480) 398-4280
(480) 398-4281
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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