Individual
KIMBERLY JEAN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
121 STOCKTON AVE, WALTON, NY 13856-1430
(607) 865-2155
Mailing address
9 SENECA ST, SIDNEY, NY 13838-1542
(616) 366-6495
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003675
IL
Other
Enumeration date
10/12/2017
Last updated
04/28/2025
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