Individual
TERESA MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12100 WORNALL RD, KANSAS CITY, MO 64145-1764
(816) 572-0014
Mailing address
1316 N INCA DR, INDEPENDENCE, MO 64056-1228
(816) 572-0014
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2018015033
MO
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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