Individual
STEPHANIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT, OTR
Contact information
Practice address
1430 E MADISON ST, SOUTH BEND, IN 46617-2427
(617) 308-6461
(617) 308-6461
Mailing address
1430 E MADISON ST, SOUTH BEND, IN 46617-2427
(617) 308-6461
(617) 308-6461
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008874
IL
Other
Enumeration date
03/26/2010
Last updated
10/05/2015
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