Individual
AQUESHA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
1799 MISSION PARK CT, LOGANVILLE, GA 30052-7511
(678) 794-2445
(770) 979-2591
Mailing address
1799 MISSION PARK CT, LOGANVILLE, GA 30052-7511
(678) 794-2445
(770) 979-2591
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT003614
GA
Other
Enumeration date
10/12/2006
Last updated
07/09/2007
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