Individual
BRIANNA NICOLE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
N26W23977 WATERTOWN RD, WAUKESHA, WI 53188-1006
(262) 523-0933
Mailing address
12307 W CATHEDRAL AVE, WAUWATOSA, WI 53226-3837
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5716-27
WI
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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