Individual
MS. LESLIE ANN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
404 W WILLOW RD, DALE, IN 47523-8947
(812) 937-4489
(812) 937-7101
Mailing address
404 W WILLOW RD, DALE, IN 47523-8947
(812) 937-4489
(812) 937-7101
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001820A
IN
Other
Enumeration date
04/19/2010
Last updated
04/19/2010
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