Individual
TERESA ILIANA MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1041 S MAIN ST, BURBANK, CA 91506-3205
(818) 843-2330
Mailing address
7636 FULTON AVE APT 106, NORTH HOLLYWOOD, CA 91605-1826
(818) 524-8146
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5050
CA
Other
Enumeration date
09/05/2022
Last updated
09/05/2022
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