Individual
MICAELA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11154 HURON ST STE 101, NORTHGLENN, CO 80234-2329
(381) 062-4720
Mailing address
1011 COLORADO BLVD APT 1302, DENVER, CO 80206-3558
(920) 850-7578
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0005650
CO
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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