Individual
MRS. SHARIDANM A. MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
7540 N 19TH AVE, PHOENIX, AZ 85021-7967
(888) 873-4221
Mailing address
3117 E LA COSTA PL, CHANDLER, AZ 85249-3961
(480) 786-0591
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1751
AZ
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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