Individual
MRS. JENNETTE LORENE MARTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1524 DUFFER DR, CHESTERTON, IN 46304-8859
(219) 983-1557
(219) 983-1557
Mailing address
1524 DUFFER DR, CHESTERTON, IN 46304-8859
(219) 983-1557
(219) 983-1557
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31002357A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200679570
FIRST STEPS PROVIDER NUMBER
IN
Enumeration date
01/08/2007
Last updated
05/13/2008
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