Individual
AUTUMN-RAINE MARTINEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2743 GILLMORE ST, EAST ELMHURST, NY 11369-1901
(646) 229-7138
Mailing address
2743 GILLMORE ST, EAST ELMHURST, NY 11369-1901
(646) 229-7138
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
022036
NY
Other
Enumeration date
09/03/2018
Last updated
09/03/2018
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